Wiki 20550 twice?

[KPriceAZ08]

We have a patient with trigger fingers of right ring & small fingers. The physician used one syringe to inject 40mg Kenalog into each finger. Can we code/bill CPT 20550 twice?
Does anyone have any research to support this?

Thanks for your help -
Kristen

 

[jkyles]

If this is for Medicare or a payer that uses the CCI Medically Unlikely Edits, 20550 has a MUE of 5.

 

[Orthocoderpgu]

Each finger must be treated separately, so yes, this is correct and frequently coded in ortho. Be sure to use the finger modifiers to show which finger is being injected.

 

[KPriceAZ08]

Adding a new twist to injection scenario -
I have the note where physician injected the two fingers through one needle stick ... and question whether to charge for two injections. I've read where
if you inject two different muscle groups you can bill for two injections.
Physician discussed patient's trigger fingers: "we discussed the role of repeat injection to the ring finger and a first time injection for the small finger. Under aseptic technique, 0.5 mL of Kengalog 40mg/mL was injected into the subcutaneous area above the A1 pulley to the ring finger and a bandage was applied. There were no complications. And through the same needle stick, the needle was redirected, and 0.5 mL of Kenalog 40 mg/mL was injected into the subcutaneous area above the A1 pulley to the right small finger."
Thanks again for your help -
Kristen