Our physician billed BCBS Medicare Advantage for a bilateral knee injection and a unilateral left hip injection on the same visit. We billed 20611-50 for the knees, and 20611-59-LT for the left hip. The unilateral code was denied and upheld after we appealed with records. The insurance told us "Once a bilateral code is billed you can't submit a second line with unilateral modifier."
I am aware 20611 has an MUE of 2, but they do not list MUE or units as a reason for the denial, and we have medical necessity anyways. It seems as if they just don't like the way we coded it. Can anyone advise on the coding here?
I am aware 20611 has an MUE of 2, but they do not list MUE or units as a reason for the denial, and we have medical necessity anyways. It seems as if they just don't like the way we coded it. Can anyone advise on the coding here?