# Bilateral trigger finger injections



## celcano (Mar 17, 2016)

My physician did bilateral trigger finger injections on the rt and lt 3rd digit and rt and lt 4th digits.  He bill 20550-50 X1 unit.  20550 has an MUE of 5, so I know I can bill more than the 1 unit.   What is the appropriate way to bills this?  Do I bill 20550-50 X 2 or break this down into 4 lines identifying each finger injected?

Thank you all for your assistance.


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## dwaldman (Mar 19, 2016)

It probably will come down to how the payer can process the claim. There might be an issue with quantity 2 and the 50 modifier. Instead it could be listed as below given these are separate tendon sheaths injected bilateral with a total of 4. It appears the injection(s) in the plural form is for the single tendon sheath or ligament stating if one or multiple injection for that specific tendon sheath not just one unit per side or extremity is the way it appears.

20550-50
20550-50 51


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## mitchellde (Mar 20, 2016)

dwaldman said:


> It probably will come down to how the payer can process the claim. There might be an issue with quantity 2 and the 50 modifier. Instead it could be listed as below given these are separate tendon sheaths injected bilateral with a total of 4. It appears the injection(s) in the plural form is for the single tendon sheath or ligament stating if one or multiple injection for that specific tendon sheath not just one unit per side or extremity is the way it appears.
> 
> 20550-50
> 20550-50 51



I would not use bilateral modifier for fingers as fingers are not bilateral , you have 10.  Bilateral is for paired organs or body parts.  I would recommend to use either the finger modifiers or the XS modifier and list on separate lines.
20550 F2
20550 F7
Or
20550
20550 XS


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## celcano (Mar 22, 2016)

Thank you for your assistance. I really appreciate the input from you all.


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