Wiki 20550 w/ 50 modifier?

[moviechick547]

I have been reading conflicting references about this subject. Can anyone help? I have a procedure where the physician did ligament origin insertion injections. He did 3 different ligaments on one side and then stated that he did the other side the same, so bilaterally. Here is the text below....

The paraligamentous structures including the iliolumbar ligament, posterior interosseous ligament, and sacrotuberous ligaments origin insertions thereof were injected with a total of 0.5 ml of Kenalog 40 and 3 ml of Marcaine 0.25%

The exact same procedure was repeated on the opposite side.

So, I have 6 injections. How are they reported for non-medicare? (1) 20550, 20550-59 x 5. (2) 20550-50 x 3. OR (3) 20550-RT, 20550-LT, 20550-RT-59 x 2, 20550-LT-59 x 2?

I have read and researched this and have found that you can use the 50 with 20550 and I have read where you can't. Either way, I am getting MUE edits when I run it through the encoder, but that is for medicare, correct?

Thanks!
Janet

 

[moviechick547]

Oops.....the #2 choice should be 20550-50, 20550-50-59 x 2. Sorry about that.

 

[sopka9476]

I do not code bilateral for 20550... for a bilateral procedure itemize them out and attach -76 to second code. As far as coding for all six, I would just make sure with your doctor that it is in fact 6 separate tendons being injected. If multiple injections into same tendon on both sides code just bilateral. Not sure I would try to bill for anything more than two injections.