Wiki Bilateral 20610

[mmoore70]

My doc is doing Bilateral injections on knee w/bilateral injection of Depomedrol 80 mg. Do I code 20610-50 and double the charge and code J1040-50 and double the charge. I'm having issues with getting reimbursements billing this way. One insurance company explained that the 20610 already included multiple injections but the only thing that I've come across is if it's for the same joint then you wouldn't bill multiple injections. But these injections are for both right and left knee. Please help.

 

[PeaPod1]

We bill this code quite frequently and do not have any problems using the 50 mod. You could try 20610 RT and 20610 LT..
Good Luck.

 

[mmoore70]

Thank you so much. That helps tremendously.

 

[RebeccaWoodward*]

My doc is doing Bilateral injections on knee w/bilateral injection of Depomedrol 80 mg. Do I code 20610-50 and double the charge and code J1040-50 and double the charge. I'm having issues with getting reimbursements billing this way. One insurance company explained that the 20610 already included multiple injections but the only thing that I've come across is if it's for the same joint then you wouldn't bill multiple injections. But these injections are for both right and left knee. Please help.

Your carrier is incorrect. 20610 has a bilateral payment indicator of "1".

1=Bilateral Surgery (50) 1 = 150% payment adjustment for bilateral procedures applies

20610 is eligible for modifier 50. Modifiers can become carrier specific. Some carriers prefer 50, some prefer LT/RT, some 2 units, etc, etc.

When posting 20610 bilaterally, I post 20610-50 and manually double the fee. Also, many carriers have a local coverage determination for this code. Some carriers follow Medicare's guidance on DX's that warrant medical necessity.

 

[Bella Cullen]

My doc is doing Bilateral injections on knee w/bilateral injection of Depomedrol 80 mg. Do I code 20610-50 and double the charge and code J1040-50 and double the charge. I'm having issues with getting reimbursements billing this way. One insurance company explained that the 20610 already included multiple injections but the only thing that I've come across is if it's for the same joint then you wouldn't bill multiple injections. But these injections are for both right and left knee. Please help.

When I bill this I bill:
20610-RT
20610-LT
J1040 x2 units because I don't think you can put a 50 modifier on a J code.