# 20610 Modifier 50



## Anduiza05

I have a question regarding billing for Aspiration/Injection (eg, shoulder, hip, knee joint, subacromial bursa).  My office is confused on how to code for the following scenario to Medicare: Injection of right knee and right hip, same day injection of the left knee and left hip.  How would we code this?  
20610-50
20610-50-59
20610-x 4
According to an article I found on CMS the following would apply:
"For procedure 20610, modifier 50 is appropriate when billing a bilateral injection only. Modifier 50 is usually not appropriate when billing a bilateral injection along with an injection in another body area.  The correct billing of this scenario would be to list 20610 on one line of the CMS-1500 claim from with 3 indicated in the unit field. In situations where a provider performs bilateral injections (the right and left knee) and provides no other injections the bilateral services should be billed on one lien as 20610-50 with 1 unit."

What does this mean do we bill the four units I am so confused also, if you have any direct website links that would help. 

thank you

Theresa


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## Walker22

I would bill that scenario as follows

20610-50 (dx 719.45)
20610-50-59 (dx 719.46)

BUT.. based on the article you quoted, it would seem that 20610x4 would also be appropriate. I wish I could be more help on this one...


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## RebeccaWoodward*

This may be carrier specific. I would also bill as (based on my carrier)...

20610-50 
20610-50-59

...along with the appropriate ICD-9 codes....


Here's the entire article...

http://www.wpsic.com/medicare/j5macpartb/publications/news/archived/code20610mod50.shtml


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## Anduiza05

I will check with our local carrier. Thanks


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