Wiki 20610 with j7321

[MarkG01]

One of my providers performed CPT 20610 on both knees during an Office visit. Am I correct coding as:

99212-25

20610-RT x 1 unit
J7321-EJ RT

20610-LT x 1 unit
J7321-EJ LT

Thanks...............

 

[ortholg@yahoo.com]

I think you're correct coding-wise.. But maybe not on the ej modifier.

First, j7321 is for the medication called supartz/hyalgan, and that's usually given over a course of 5 weekly injections (each one about a week apart).

According to medicare, the ej modifier only gets attached to the "j" codes for injections 2-5.. So only after the initial one in the series.

That is my understanding.

 

[Donna T]

I agree. If it was decided during the course of the office visit to do the 1st of 5 injections then you would bill the E/M with a -25 modifier along with the 20610 and J7321 - otherwise you'd bill injections 2-5 with no E/M and an EJ modifier attached to the J7321.

Donna

 

[MarkG01]

Thanks

Thank you both for the clarification.....