Wiki Cpt 20550, 20552

[enjoycoding]

Billed to Medicare in the following order: 99213 / 25...20552....20550/ 59. Charge amount the same for the injections. Medicare denied 20552; denial reason B15/M80, "this service/procedure requires that a qualified service/procedure be received and covered....the qualifying other service /procedure has not been received/adjudicated, not covered when performed during the same session". Thanks.

 

[aaron.lucas]

Those are bundling denial codes, which means there is an NCCI edit on this. 20552 is column 2 code for 20550. And it's a soft edit, which means that 20552 may not be biled along with 20550 unless a modifier is applied to 20552. So, I would move the -59 to the 20552 (assuming the documentation supports that the injections are separate) and re-bill that way.