Outpatient Facility Coding Alert
20552 Might Be Bundled Into 20610
Question: Is 20552 bundled into 20610?
New Jersey Subscriber
Answer: According to the latest Correct Coding Initiative (CCI) edits, you cannot bill 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]) with 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) in the same anatomic location.
Pay attention: If the injections are administered in different anatomic locations, you can report both codes. However, because code 20552 is a Column 2 code for 20610, append a modifier to 20552 to differentiate the services and override the CCI bundle.
Tips: Trigger point codes are grouped to reflect the total number of muscles treated and not how many injections the provider performs. When the provider treats one or two muscles with injections, regardless of the number of injections, use 20552. When the provider performs trigger points on three or more muscles, you should use 20553 (Injections, single or multiple trigger point(s), 3 or more muscle(s)).
Related Articles
Outpatient Facility Coding Alert
- Coding Strategies:
Correctly Code Your Screening Colonoscopies
Take note: The screening might eventually convert to therapeutic or diagnostic. Keeping the differences straight [...] - ICD 10 Transition:
CMS Gives a Yearlong Concession Period to Get Used to ICD-10
Ensure the code belongs to the right family and avoid denials. If ICD-10 implementation still [...] - Skin Updates:
Follow 3 Steps Seize the Right Code for Pilonidal Cyst I&D
Scan through the provider’s detail to spot on the right set of codes! When your [...] - You Be the Coder:
Know the Difference Between Adult and Pediatric Hydroceles
Question: How do you differentiate adult versus pediatric hydroceles Ohio Subscriber Answer: There’s a clear [...] - Reader Question:
Shave Off the Warts With 17110
Question: A patient was taken to the operating room for wart removal, due to the [...] - Reader Question:
POS 11 Claim Needs Prior Authorization
Question: I just got a recoup payment request from United Healthcare. The physician performed 25111 [...] - Reader Question:
Choose 66982 for Capsular Tension Ring Insertion
Question: How would I bill for capsular tension ring with a complex cataract? Idaho Subscriber [...] - Reader Question:
20552 Might Be Bundled Into 20610
Question: Is 20552 bundled into 20610? New Jersey Subscriber Answer: According to the latest Correct [...] - Reader Question:
Turn to T19 Family for Stent Removal
Question: What ICD-10 code should I report for the urologist’s work removing a stent? Massachusetts [...] - Reader Question:
Bleed Site Helps Determine Epistaxis Code
Question: How do we bill for nose bleed, which generally occurs due to acute hemorrhage [...]
