Wiki Filling in as Ortho coder help needed

[alk@APS]

I am filling in as an Ortho coder and I need lots of help - my first question is if a patient get an injection into each knee can you charge for the medication once or twice? Do I add a LT/RT modifier to the medication and the injections? The injections were paid on and one of the medication codes but the second was denied as a duplicate. There was no LT/RT modifer on the medication. Thanks so much!!

 

[Donna T]

Depends on the insurance - you'd bill the injection itself on either one line item with a -50 modifier or two line items - LT, RT but the medication would all be on one line item and you wouldn't use a modifier. For example:

20610 x 2 with -50 modifier
J1030 x 2 (40 mg in each knee of Depo-Medrol)

or

20610 x 1 - LT
20610 x 1 - RT
J1030 x 2

Hopefully that helps and doesn't confuse you more!

 

[alk@APS]

Thank you!