Wiki 4 injections during e/m visit

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coderforlife

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An est medicare pt comes to the office complaining of bilat shoulder and bilat knee pain. the decision was made to inject both shoulders and both knees.Two different diagnoses. would I code the shoulders 20610 rt and lt with the diagnosis code for that issue and also code the 20610 rt and lt for the knees with that diagnosis code. Or would I use mod 59 for the knees?

Thanks
Coderforlife
 
coderforlife said:
An est medicare pt comes to the office complaining of bilat shoulder and bilat knee pain. the decision was made to inject both shoulders and both knees.Two different diagnoses. would I code the shoulders 20610 rt and lt with the diagnosis code for that issue and also code the 20610 rt and lt for the knees with that diagnosis code. Or would I use mod 59 for the knees?

Thanks
Coderforlife
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You have to use 59 otherwise they will deny it as duplicate.
 
would they deny even if we have two different diagnosis codes for the knees and shoulders? Shoulders will use 726.10 and the knees 715.36.

coderforlife
 
coderforlife said:
would they deny even if we have two different diagnosis codes for the knees and shoulders? Shoulders will use 726.10 and the knees 715.36.

coderforlife
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If human would process the claim maybe he/she would see and understand that these codes are not duplicate but Im sure computer does it so there is no guarantee it will be paid. I have billed two injections for two different part of body it was still denied. So don't risk just use -59. Is there any particular reason why you don't want to use 59?
 
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We use 20610 50 modifier and we get paid. You would use the 20610 50 twice and we also do the J code with a unit 2 double the price and it also gets paid. Good luck
grandmacora
 
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