Wiki Dupuytrens Nodule Cortisone Injection Code?

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Belton, MO
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We have always used a 20550 with J3301 (Kenalog/Cortisone) together for a Dupuytrens Nodule injection but have noticed lately this being denied. This isn't the 20527 (Xiaflex), this is strictly a Cortisone injection performed in office into the nodule. Does anyone have a code that they use besides 20550 or 20527, again this is not Xiaflex. Thanks!
 
When you say "always used", and "lately" this is being denied. Would need more specifics.
Is there a specific date of service of the claims that this started on?
Do you have a new coder or biller that is preparing the claims?
How many denials?
What insurance is denying it; all of them or only one specific?
They are definitely denials and not rejections?
What is the diagnosis code being used, are the modifiers being appended correctly?
Are you trying to bill an office visit w/ 25 modifier with the injection? Is it appropriate?
Be sure the provider is injecting the nodule/cord and not the joint. If it's the joint it is not 20550. Not saying that would happen, but could if the patient has other stuff going on in the hand.
You want to do some digging and data review to see if you can pinpoint this issue and narrow down to a specific time, payer or person billing.
I believe 20550 is correct when it is not the Xiaflex.

There is an old CPT Assistant article about it from back when the 20527 came out. There is also a newer AHA Coding Clinic from 2024 that addresses the question. https://www.findacode.com/newslette...injection-dupuytrens-contracture-H241013.html
I would check those too if you figure out everything else is correct with the claims.
 
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