Wiki J7321

[andelacruz]

Happy 2010 to everyone!!! I appreciate everyone's helpfullness on all of my questions I have had.

I have another however, Our company has billed
20610
J7321

Mcr has paid for the 20610 but the J7321 has not and they are stating that it is inconsistent w/the modifier used or a modifier is needed. I am assuming that I need one since we didn't bill one. I'm sorry but there are no coding books here at this office and I am just stumped, I need to definiately bring my books in here from class.!!!

 

[Walker22]

We bill that code all the time to Medicare without a modifier and get paid. I would check the LCD for billing guidelines. Maybe you carrier has a specific way they want it billed (L/R?).

 

[andelacruz]

Thanks

Thank you for all your help!

 

[Lisa Bledsoe]

We bill that code all the time to Medicare without a modifier and get paid. I would check the LCD for billing guidelines. Maybe you carrier has a specific way they want it billed (L/R?).

That or they denied it incorrectly.

 

[mderemer]

J7321 and modifiers

Our Indiana carrier requires an RT or LT for J7321. If both joints then J7321 needs listed separately. For the 2nd and 3rd treatment, it requires the EJ modifier.