20610

  1. J

    20610+77002, Bundling of 20610 per Noridian/Medicare and Medications Question

    We are a pain management clinic that normaly refers patients to an adjacent ASC. Recently the physician has decided to do minor large joint injections in office with fluoro, that way we can bill for medication as well. The first procedure done was a an Intraarticuluar left Shoulder injection of...
  2. R

    Wiki Billing for drugs when the administration code is bundled.

    It's generally understood that even if, due to bundling, we're unable to bill for an administration code we still bill the HCPCS code for the drug administered. For example, when a therapeutic hip joint injection (20610) is performed during the same session in the same anatomic location as hip...
  3. K

    Wiki 3 Major joint 20610 in one day

    We have a few providers that will perform multiple injections in one day for example Bilateral Knee and RT Shoulder. Medicare will pay the bilateral line then deny the third injection as missing/invalid modifier with no appeal rights. If there is a MUE of 2 for 20610 should we be performing a...
  4. J

    Wiki 20610 performed unilaterally with a bilateral diagnosis code

    Hi, I have come across the situation a few times where the provider has diagnosed a patient with bilateral OA of the knees (M17.0). During a visit, they performed a joint injection into only one of the knees. In this scenario, would you report a bilateral diagnosis code since they have...
  5. C

    Wiki 20610 MEDICARE CODING PROBLEMS

    I have a patient who came in with bilateral knee pain and right shoulder pain. Doctor Injected 40 MG Kenelog into RT knee, 40 MG Kenelog into LT knee, & 40 MG Kenelog into RT shoulder. How can I code this properly for it to go through with Medicare Primary and BCBS secondary? I tried J3301 -...
  6. KStaten

    Wiki Are all 20610 Injections considered "Intra-articular"?

    Question: Are all injections that fall under the CPT code 20610 considered "intra-articular," or does that term not apply to ALL injections that can be performed under the 20610 CPT code, such as injections into the bursa? THANKS!
    • KStaten
    • Thread
    • 20610 cpt injections intra-articular
    • Replies: 2
    • Forum: Orthopaedics
  7. KStaten

    Wiki Billing 20550 (or 20551) with 20610

    Hello, Everyone! :giggle: As usual, I have a 2-part question and would appreciate your help. 1) When 20550 (or 20550) is being billed with 20610 for two separate body parts, which modifiers would be used? Example: tendon sheath injection, left elbow bursa injection, right knee 2) Also... I...
    • KStaten
    • Thread
    • 20550 20551 20610 bursa injections modifer xs modifier separate anatomic sites tendon tendon sheath
    • Replies: 5
    • Forum: Orthopaedics
  8. C

    Wiki NY - UHC Community Plan - CPT 20611 denial N425

    Question for anyone working in New York with emphasis on Orthopedics. We have recently started getting a noticeable influx in denials for CPT 20610 & CPT 20611. The denial reason listed is N425 (statutorily excluded). These are mostly knee injections with a diagnosis of osteoarthritis. Some...
  9. C

    Wiki 20610 (multiple units and location) and Depo medrol and labs (89051/89060)

    Hi all, I've asked the questions in a few different places on here and thought it would be better if all together to show the true picture. I've read all of the AAPC articles on the subject of 20610, so I'm familiar with when in diff joint etc, but there's some confusion on joint and bursa in...
  10. S

    Wiki J7322 2017 reimbursement

    The new 2017 code J7322 for Hyaluronan or derivative, hymovis, for intraarticular injection, 1mg is not listed on the 2017 first quarter ASP file from CMS and does not pull up on the ASP fee schedule with Florida Medicare (First Coast Service Options). Just wondering if anyone has started using...
    • sarthur
    • Thread
    • 20610 hymovis j7322 medicare part b
    • Replies: 1
    • Forum: Anesthesia
  11. E

    Wiki 20611 with level 4 E/M?!?!?

    Hi All, I really need some help with this one. :confused:I have been in the medical field for 10+ years but am newly certified in coding, so I would like to come at this problem with as much data and references as I can to support my perspective. Our Sports Med guy keeps billing 20610/20611...
    • esimonsen
    • Thread
    • 20610 e/m e/m with modifier 25 overbilling
    • Replies: 1
    • Forum: E/M
  12. 5

    Wiki prepayment request from Medicare

    Hello, We bill for ASC and Medicare has started to do prepayment request for code 62311 and 20610. Is anyone else dealing with this? Right now, we will send in all the paperwork to support the patient has met all the requirements. But this delays reimbursement. Any way to do this faster or...
  13. 5

    Wiki pre payment from Medicare

    Hello, We bill for ASC and Medicare has started to do prepayment request for code 62311 and 20610. Is anyone else dealing with this? Right now, we will send in all the paperwork to support the patient has met all the requirements. But this delays reimbursement. Any way to do this faster or...
    • 574coding
    • Thread
    • 20610 62311 prepayment requirements
    • Replies: 0
    • Forum: Anesthesia
  14. A

    Wiki Cpt 20610 - Is anyone having issues

    Is anyone having issues with getting paid for 20610 from United, Humana or Aetna?? Looks like they only have knee Dx codes listed on their policy, but not taking into consideration of the other major joints.
  15. T

    Wiki Coding

    Can you bill together 20610 with 20611 or do you just bill 20611 alone to state an ultrasound was used for the injection?
  16. L

    Wiki Modifier 79-Osteoarthritis

    Hello, Can anyone tell me if I have a fractured toe (still in global period) but the patient comes in for a bilateral routine knee injections do I put the modifier 79 on both injection codes or just one. Ex: M17.0 - B/L Osteoarthritis 20610 RT - 79 20610 - LT - 79 of do you only...
    • LLRodgers
    • Thread
    • 20610 codes injection modifier osteoarthritis
    • Replies: 2
    • Forum: Orthopaedics
  17. A

    Wiki 20551 vs 20610

    M Doctor is billing a 20551 and I do not agree with the procedure she chose. I think she should have billed a 20610 because she injected into the left trochanteric bursa. Her note indicates Patient with rheumatoid arthiritis and currently on Plaquenil therapy. According to the patient she is up...
    • aparscal
    • Thread
    • 20551 20610 bursa patient trochanteric
    • Replies: 4
    • Forum: Rheumatology
  18. D

    Wiki 20610 - I need some expert advice

    I need some expert advice on coding arthrocentesis and joint injection. A Medicare patient presents with an ear problem and knee pain. The physician addresses the ear problem then decides to drain fluid from the knee and inject it with Kenalog. My question is can he bill for the...
  19. C

    Wiki 20610 anterior and posterior

    Our doc is injecting 1 shoulder (or major joint) but indicating on the superbill that there were multiple anterior & posterior sticks. Thus, he wants to bill 20610 twice (for the anterior and posterior). Has anyone seen this? JC
  20. krburke

    Wiki How best to report bilateral 20610 to Medicare

    One of my providers has given 20610 injections in both knees. How does Medicare want to receive these codes? These are the options I came up with: 20610-RT x 1 unit 20610-LT x 1 unit OR 20610-50 x _ units? Would this be billed as 1 or 2 units? Any other modifier besides -50? I have not had...
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