# Mulitple procedures+E/M



## thefosterfarm (Jun 23, 2008)

I would just like to throw this out there to get some opinions on how to appropriately bill.  I have an office visit, with diagnosis of DJD, and Skin Lesion.  Next there were steroid injections to the R hip Bursa, Medial Collateral Ligament of the R Knee, and the Sartorius Muscle R Knee.  Any suggestions as to the best way to approach this would be greatly appreciated!


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## daniel (Jul 4, 2008)

Not saying this is correct, but was just snoopoing around on this sight. Came across your posting. This is what I came up with. But just going off what you wrote, I came up with this. But when I have questions regarding this procedures. I bring the book straight to the physician. And ask them what exactly was done. And which cpt codes fit. Mainly pertaining to 20550, 20610range. 

http://physicianservices.carilion.com/CodingCorner/menu2.htm

Check this site out, it's pretty informative. May help.

Regarding the E/M, if he addressed. The skin lesion, and ask the patient to return for a biopsy of some sort. You can get an easy Level 2. But if he went more in depth with the DJD and spent some time with patient (outside) of the injections. Then a higher level E/M is warented. 





steroid injections to the R hip Bursa- 20610
I'm sure this ones right


Medial Collateral Ligament of the R Knee, -20550-59
Just throwing this one out there. Not sure if this is right.

the Sartorius Muscle R Knee-20552-59
Just throwing this one out there. Not sure if this is right.


Respectfull
Daniel
CPC


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## rthames052006 (Jul 4, 2008)

magpiesj said:


> I would just like to throw this out there to get some opinions on how to appropriately bill.  I have an office visit, with diagnosis of DJD, and Skin Lesion.  Next there were steroid injections to the R hip Bursa, Medial Collateral Ligament of the R Knee, and the Sartorius Muscle R Knee.  Any suggestions as to the best way to approach this would be greatly appreciated!



I've seen this type of scenerio come up before.  Just make sure the documentation supports each service and make sure you use the proper modifiers, without my books with me at home, I'd say you need mod 25 on the visit and either 51/59 on the procedures. Make sure you have your proper dx usage on the procedures, you may have to send notes in, depending upon the insurance company your pt has.

Good luck,


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