Wiki 20526 - Carpal Tunnel

[graceroni13]

So I've been getting denials for bilateral carpal tunnel injections saying that it exceeds the amount able to be billed in one day. I usually bill it at 20526 RT then 20526 LT with the 354.0 DX. Do I need to use a modifier 51? I don't think 59 would be appropriate... And I don't use modifier 50 that much. The denials have been coming from Medicare mostly. Any suggestions?

 

[dclark7]

20526 has an MUE (medically unlikely edit) of 1. Medicare wants one line, one unit with a 50 modifier and they will pay at 150% of the allowed amount.

 

[graceroni13]

oh thank you so much!!!