Wiki need help with injection modifiers

Create Wiki
J

jamiejoy

New
Messages
3
Location
Winston, MT
Best answers
0
I need help with the new billing a joint injection 20610 and an ultrasound guided nerve injection 76942, 64450 during the same visit. My doc did an unguided knee injection and then did and ultrasound guided occipital injection. My clearing house keeps rejecting it because 20610 and 76942 are bouncing off each other. I have tried 59 modifier on both 76942 and 20610. Does anyone have any suggestions? Thanks
 
You will also need a modifier on 64450. According to CCI edits 64450 and 76942 are both column two codes to 20610 (even though 64450 has higher RVUs than 20610)
 
I understand that I need modifiers on the injections. My trouble is that 76942 and 20610 are hitting together now that we have the new joint codes that include ultrasound 20611. How do I get 76942 and 20610 to even get past my clearing house let alone insurance pay?
 
Can you try to set it to paper? Or split the superbill?
Also, many insurance companies allow you to submit claims directly though their websites- which is a pain because of data entry, but an option.

I have had to make calls to my clearing house to have them fix coding issues in the past.
 
Last edited:
speaking of modifiers, and depending on carrier, are any of you having sucess in using the new subset modifiers such as XS or XU in situations such as these? Following this thread closely, because we have a number of claims "pending for medical records documentation " to see if these multiple procedures will be paid. Seem to always trigger the editing blocks and can be quiite a pain.
 
You must log in or register to reply here.
Top