Wiki Osteoarthritis knee diagnosis billing

[Kathy615]

How would you bill the diagnoses for: a consultation for bilateral osteoarthritis of the knee M17.0, and patient has an arthrocentesis w ultrasound 20611 on the Left knee for the osteoarthritis M17.12 on the same visit. Can the M17.0 and M17.12 be billed on the same claim?
99243-25, M17.0
20611-LT, M17.12
Thank you

 

[ollielooya]

I don't see why you can't bill this way. You specified in more detail for the procedure that was performed on the left side, adding modifier 25 to the consult visit for the BILATERAL diagnosis. I'd like to see what others will add to this!

 

[mitchellde]

I would need to see the note to determine the dx. However it does not make sense to me to use these DX codes together.

 

[ollielooya]

Debra, glad you replied to this thread. It's a good spin-off from another one questioning about the bilateral diagnosis versus a procedure performed using a unilateral code. Do you remember dealing with that one too? Is this another case whereby even though the visit resulted in the doctor assigning a bilateral diagnosis code, the actual procedure just focused on one side, thereby questioning whether the initial diagnosis was the best choice? And yes, the chart notes would help to confirm what would be appropriate.

Enlightenment is indeed welcomed, as one of our doctors was wondering how best to code a similar scenario!