Wiki Injection-Knee

[svms]

I am looking for some guidance.

My doctor injected patient in two separate compartments on the left knee. The pes anserine and also fibular collateral ligament.

Is it okay to bill 20610 2x's for the same knee??

Where can I find some guidelines for coding in this fashion?

 

[MarcusM]

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/downloads/modifier59.pdf

"Modifier 59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries)not ordinarily encountered or performed on the same day by the same physician."

 

[OCD_coder]

This code can only be used once per AMA CPT Asstant guidelines and an Orthopedic Pink Sheet. The AAPC also teaches this in several of their webinars I have seen over the years. Here is encoderpro's coding tip....

These codes should be reported only once even if both an aspiration and injection is performed during the same session.

Note: Since the injections were performed in the same anatomical area, it would not meet the modifier 59 requirements as the knee compartments are contiguous structures.

This question has been addressed previously, see this posting:
https://www.aapc.com/memberarea/forums/showthread.php?p=123433