Wiki modifiers on joint injections when billing MCR

[ttcoding]

I have a pt that had multiple joint injection to the left and right side of the ankle. We billed it as following
20600-LT
20600-RT/51
20600-LT
20600-RT/51

Should we have billed it as
20600-RT/LT/50
20600-RT/LT/51

Please help MCR has denied clm.

Thanks

 

[cmcgarry]

Do you mean the patient had both the left and right ankle done? Your question sounds like one ankle, both the left and right side of that one ankle?

20600 is for a small joint; 20605 is for an intermediate joint - so the correct code is 20605 for the ankle.

If only one ankle, it would only be one code, 20605. If both the right and left ankles, you would bill 20605-50 to Medicare (at least our MAC wants it on one line with a 50 modifier). An alternate to one line with the 50 modifier is 20605-LT on one line, and 20605-RT on the other.

Hope this helps,

 

[banderson77]

If the injection is in the medial and lateral side you can only bill for one injection. If it is both ankles then you really don't even need the 51 modifier. RT/LT is all you need.

 

[ttcoding]

so if the pt had procedure 20605 preformed to the medial and lateral side of both ankles. We could only bill one injection with RT/LT?

 

[cmcgarry]

so if the pt had procedure 20605 preformed to the medial and lateral side of both ankles. We could only bill one injection with RT/LT?

Please see my previous post - if done on both ankles, you could then bill one line with the 50 modifier or two lines, one with RT and one with LT, depending on what your carrier/MAC prefers.