Wiki 20526 - Carpal Tunnel-injections

[graceroni13]

So I've been getting denials for bilateral carpal tunnel injections saying that it exceeds the amount able to be billed in one day. I usually bill it at 20526 RT then 20526 LT with the 354.0 DX. Do I need to use a modifier 51? I don't think 59 would be appropriate... And I don't use modifier 50 that much. The denials have been coming from Medicare mostly. Any suggestions?

 

[marvelh]

For Medicare physician services, bilateral procedures should be billed with modifier 50 and 1 unit of service on 1 line item.

Your denials are probably due to 20526 has a Medically Unlikely Edit limit of 1 or a maximum of 1 unit of service per date of service.

 

[graceroni13]

Thank you so much!

 

[dlashua]

Don't forget to increase the price of the procedure.

 

[Urvishah]

with fluroscopy

What about using fluroscopy , do we need to add 77002 with 59 modifier ? or we don't need any modifier?