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Wiki JOINT INJECTIONS

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swiessner

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SAULT SAINTE MARIE, MI
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Hi all, I know there are a ton of joint injection questions out there and believe me I have been going through all of them. Medicare plus Blue is denying my large joint injection 20610 with denial

CO 16: Claim/service lacks information which is needed for adjudication. Does anyone know if I am just billing 1 injection and the kenalog x 4 to any medicare insurance what it should look like. Thanks in advance​
 
Is there another remark code or any other information on it along with the CO16?
It could be a lot of things. Does your diagnosis match the correct joint and laterality? Are all the other data elements correct on the claim such as member name, DOB, M/F, DOS, etc.? Is the NDC correct?

What does your coding look like and what joint was it?
 
Thank you for replying. They paid for the kenalog portion so I am assuming all the patient info is correct.
CO-45 Charges exceed your contracted/ legislated fee arrangement.
CO-253 Sequestration - reduction in federal payment
CO-16 Claim/service lacks information which is needed for adjudication.
N822
These are all the denials that I received for this claim
 
The N822 remark code is your answer. Normally when there is a CO16 there is an additional remark for more info.
Check your modifier and laterality on the dx would be my suggestion. RT/LT conflict I bet.
 
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