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Tstanko50

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We have a Medicare patient who the Doctor wants to charge a 20610 twice with mod 76 because he is asperating and injecting in the same sight is this possible to bill code twice mod 76 was the only one we could come up with. It states in the cpt book asperation and or injection so I did not think could bill code twice but he is doing both. please advise
thank you
Tracey Stanko CPC
 
Injection in same joint

Many Medicare carriers do not allow for reimbursement when the same joint is injected twice. There is no Medically Unnecessary Edit (MUE) on this code and no guidance from the Georgia Medicare Carrier so I would suggest you contact them and ask for their guidance.
 
The same Joint is not being injected hes asperating first then injecting same sight. Is that what you are referring to I am in Texas :)
thank you
Tracey Stanko CPC
 
You cannot use the 76 because it is not the exact same procedure being repeated in a different setting. One is aspiration and one is injection and both are performed in the same session. There are several CPT assistants on this and one of them covers this scenario and states you can only bill for one.
 
mitchellde said:
You cannot use the 76 because it is not the exact same procedure being repeated in a different setting. One is aspiration and one is injection and both are performed in the same session. There are several CPT assistants on this and one of them covers this scenario and states you can only bill for one.
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Can you please give me that assistant and scenario if you would not mind I am trying to explain this to a Doctor
thank you very much for your assistance you have been very helpful I think it will help if I have something to show
:)
 
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