Wiki Injection admin. Code for trigger finger

[CapeCodYankee]

Hi everyone,


I need some guidance. We billed Medicare the following:

99212 (25), 20600(F3) and J1030- patient DX: trigger finger,swelling of limb & pain in finger

Medicare is denying both 99212(25) & 20600(F3) as inclusive and only paid on drug J1030?

SHOULD the admin. CPT be corrected to 20552 for trigger point injection rather than injection of small joint/finger.toe 20600?

I'm not sure whether to tell biller to contact MCR regarding this denial for better clarification or to correct injection admin. code as noted above.

Any replies greatly appreciated!! thanks to all in advance!

 

[CarrieE]

Try using the 20550 Tendon sheath or Ligament code. The 20552 is for injecting muscles...hope that helps

 

[PLAIDMAN]

I agree..........I use 20550

 

[riverw]

20550

our 20550 is being denied how are you billing?

 

[PLAIDMAN]

20550 F7 (which ever digit applies) 727.03

the office visit will probably not be paid.....there is a portion of the rvu in all injection codes for an e/m -

What was reason for denial on 20550?

 

[Laxwido]

Denial might be because of the F7. 20550 is not a "finger" specific code, like a PIP joint or a phalanx. I had a number of these that paid once I removed the finger modifiers.
Good Luck!

 

[PLAIDMAN]

Denial might be because of the F7. 20550 is not a "finger" specific code, like a PIP joint or a phalanx. I had a number of these that paid once I removed the finger modifiers.
Good Luck!

LOL..I love how consistent payors are...I have never been denied for the finger modifier

they are probs just denying ...hoping you wont appeal