Wiki 20552

[PLAIDMAN]

Is anyone having a problem getting Medicare to pay for 20552, I can't seem to get them pay, even when the Doc is specifically stating what muscle he injected????

 

[RebeccaWoodward*]

Is anyone having a problem getting Medicare to pay for 20552, I can't seem to get them pay, even when the Doc is specifically stating what muscle he injected????

Our local Medicare has a LCD on this procedure code. What diagnosis code did he report?

 

[PLAIDMAN]

He states pt has 723.4 ; 729.5 (for arm) ; 723.1 ; 728.85.

Do you think another injection code would be more appropriate??

thanks

 

[RebeccaWoodward*]

For our state, 723.1 (CERVICALGIA ) is the only accepted diagnosis code that you've listed; however, not knowing what was done, where/how/why...I really can't offer any coding advise.

Can you provide exactly what the patient dictated? (without any identifying information)

The link below are LCD's for each state. You can search by state and topic.

http://www.cms.gov/mcd/results_inde...ent+Services+(05535)+-+Carrier&letter_range=4

 

[PLAIDMAN]

Doc states:

"under sterile technique a trigger spot in left posterior muscle region at the base of his neck was injected"

"his symptoms are still spasm and pain in the left side of the neck and the base of the neck with radicular type symptoms down the arm"

"emg confirms chronic C5,6,7 radicualr pattern and carpal tunnel"

 

[RebeccaWoodward*]

Doc states:

"under sterile technique a trigger spot in left posterior muscle region at the base of his neck was injected"

"his symptoms are still spasm and pain in the left side of the neck and the base of the neck with radicular type symptoms down the arm"

"emg confirms chronic C5,6,7 radicualr pattern and carpal tunnel"

Based on:

"under sterile technique a trigger spot in left posterior muscle region at the base of his neck was injected"

"his symptoms are still spasm and pain in the left side of the neck and the base of the neck with radicular type symptoms down the arm"

If the provider linked 723.1 to 20552, you should be able to re-submit a corrected claim.