Neurosurgery Coding Alert

Question: How should I code bilateral lateral epicondyle injections?

Minnesota Subscriber

Answer: You have two potentially acceptable options, depending on the situation:

• CPT 20550-- Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia")

• 20551 -- ... single tendon origin/insertion.

The procedure note should be clear regarding whether your physician injected the tendon sheath or tendon origin/insertion; once you determine this, you can assign the correct code.

Modifier catch: You'll also report a modifier to indicate the injections were bilateral. Modifier 50 (Bilateral procedure) isn't recognized in conjunction with 20550, so you'll include modifiers LT (Left side) and RT (Right side) if 20550 applies. If you report 20551, append modifier 50.

-- Technical and coding guidance for You Be the Coder and Reader Questions provided by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.