Wiki Injection denial

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LLRodgers

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Hello,

Can anyone help me with this.

Patient had osteoarthritis in both knees and has had injections in both knees in the past, then the patient ended up with a meniscal tear in the right knee and had surgery for that meniscal tear.

The patient then came in 2 months after the surgery and had bilateral knee injections due to Osteoarthritis. Insurance paid for both the medicine and one injection code saying the other one was under the post op. We added a modifier 79.

I feel these are 2 different diagnosis - Osteoarthritis and Meniscal tear and the patient has had the Osteoarthritis long before the meniscal tear.

So does anyone have a suggestion on how to get this coded or am I wrong in my thinking?

Thank you,
LLR
 
SIDENOTE: AETNA won't pay for any meniscectomies unless you have documented primary or posttraumatic (mild or worse) osteoarthritis and traumatic meniscus tears per policy bulletin 0673.

Peace
@_*
I, too, am curious of your claim status.
 
Injection during post op

I feel 24 modified on the injection for the operative knee is a better choice since it is not a return to operation done in office for oa
 
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