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Wiki 20550 use modifier 50 or not?
- Thread starter gizmo1002
- Start date
torresreb
Networker
You would use the RT/LT modifiers etc .... (see link)
Procedure code 20550 is not subject to bilateral surgery rules. Therefore these services should not be billed with procedure code modifier 50 (Bilateral Procedure).
2. However, procedure code 20550 is subject to multiple surgery rules (Modifier 51). It is recommended that you bill all services at 100% of billing charge. Let the insurance carrier apply, the reduction in reimbursement.
Procedure code 20550 is not subject to bilateral surgery rules. Therefore these services should not be billed with procedure code modifier 50 (Bilateral Procedure).
2. However, procedure code 20550 is subject to multiple surgery rules (Modifier 51). It is recommended that you bill all services at 100% of billing charge. Let the insurance carrier apply, the reduction in reimbursement.
torresreb
Networker
i believe you would. here is another link regarding the use of 20550 and 51
if your provider is focusing on those shoulder hip elbow and knee joint injections the 20550 would not be the correct code. you would need to look into the 20610 for large joint and 20611 if guidance was used. Medium joint is 20605
SLBooker
Guest
Hi gizmo1002,
I work in Pain Management and do Tendon, TPI (Trigger Points) and Joint Injections on a daily basis. I agree with wendy.moore@honorhealth.com, if your provider is injecting the shoulder, hip, elbow and knee - these sound more like "joint/bursa" injections. You would need to review the wording of your provider's documentation and note whether they state tendon (20551), muscle (20552-53) or joint "aka intra-articular space." You will also need to note what type, if any, guidance was performed as Ultrasound is inclusive with the joint codes BUT flouro can be billed separately. To add to wendy.moore@honorhealth.com comment, if US guidance used bill 20611 for shoulder, hip and knee AND 20606 for elbow. If flouro was used 20610 x3 77002 AND 20605 x1 77002. Hope this helps, for such a simple procedure the coding, in my opinion, is not quite as simple
I work in Pain Management and do Tendon, TPI (Trigger Points) and Joint Injections on a daily basis. I agree with wendy.moore@honorhealth.com, if your provider is injecting the shoulder, hip, elbow and knee - these sound more like "joint/bursa" injections. You would need to review the wording of your provider's documentation and note whether they state tendon (20551), muscle (20552-53) or joint "aka intra-articular space." You will also need to note what type, if any, guidance was performed as Ultrasound is inclusive with the joint codes BUT flouro can be billed separately. To add to wendy.moore@honorhealth.com comment, if US guidance used bill 20611 for shoulder, hip and knee AND 20606 for elbow. If flouro was used 20610 x3 77002 AND 20605 x1 77002. Hope this helps, for such a simple procedure the coding, in my opinion, is not quite as simple