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Wiki 20551 multiple injections

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pammalou

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I have a dilema where we are having an issue getting reimbursed for billing out 20551 with multiple injections. They are to different origin/attachments, some times bilaterally. I have been using a -59 and sometimes paid, sometimes not. I don't believe -76 is the answer because it is not a repeat to same area. Help!!
 
Help with 20551 please

How would you code this out properly?

Procedure description: The patient is brought to the procedure room laid prone, and pillows are placed under the chest to better position the patient. The skin of the neck is scrubbed with Betadine x3 this is allowed to dry and wiped clean with alcohol. The skin is marked surgical marking pen. Skin anesthesia was accomplished with 1% lidocaine without epinephrine. The patient had injections done today to the superior occipital ridge at the Rectus Capitis Posterior Major and Minor muscles both right and left. We also treated the supraspinous ligament C2, C3, C4, C5, C6, C7. I then treated the Neck attachment of the Rectus Capitis Posterior and the Inferior Obliqus muscle attachment on C3 both right and left. Lastly, I treated the Rotatores cervicis at C3, C4, C5, and C6 both left and right. Treatments were done today with Marcain. The patient tolerated the procedure well, there were no immediate complications. They will follow up in 3 weeks. Basic post injection cares were discussed.
 
20551 is for "single tendon origin/insertion", looks like you are treating muscles (?), that would be either 20552 (1-2 muscles) or 20553 (3 or more muscles). Looks like you may also be able to bil 20550 for the ligament injections. I would bill 20550 and 20553,59 for this; per CCI a modifier is allowed and I believe your notes support this use.
 
Thank you...we seem to be running into these types of situations alot lately and I need to get my hand wrapped around these codes...I appreciate all your help.
 
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