Wiki 20550 and 20553

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Aurora, CO
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I have a claim with 20553 and 20550 on it. Select Health paid 20550, but denied 20553 as a bundled service. Notes read: trigger points along trapezius muscle were injected... and C4-5, C5-6, and C6-7 posterior spinous ligaments were injected...

Am I missing a modifier? I know I can add -51 to 20550, but that code was paid. Everything I've read says not to use a modifier with 20553.
 
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