Wiki PRP HIP injection under Fluoro

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joanne71178

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What is the correct way to code this procedure?
20610-22
77002-26?

The insurance is BCBS, but the doctor is not participating. This was performed in the hospital under anesthesia.

Thanks in advance!:confused:
 
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I work for the billing (EHR) company. I am not sure if the office got an ABN signed. This is performed at the hospital in CA by a Nonparticipating Dr. Recently I was audited and the auditor told me not to bill the 0232T; which is what I was coding at $1000. She told me to add a 22 modifier to the procedure, but this does not seem correct. seem the 20610 is only $190.

the modifier 59 was a typo, it should have been mod 22
 
joanne71178 said:
I work for the billing (EHR) company. I am not sure if the office got an ABN signed. This is performed at the hospital in CA by a Nonparticipating Dr. Recently I was audited and the auditor told me not to bill the 0232T; which is what I was coding at $1000. She told me to add a 22 modifier to the procedure, but this does not seem correct. seem the 20610 is only $190.

the modifier 59 was a typo, it should have been mod 22
Click to expand...

who audited your notes on PRP injections? I haven't seen many 22 mods on injections.
 
It was a PRP injection with a surgery; she said to add the 22 to the surgery code. it was a private auditor in Southern CA.
 
joanne71178 said:
It was a PRP injection with a surgery; she said to add the 22 to the surgery code. it was a private auditor in Southern CA.
Click to expand...

I wouldn't do that as the PRP injection is a part of the surgical payment. 22 mods are hard enough to get paid already and adding the PRP really doesn't justify an additional 10-15% payment.
 
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