Bilateral heel spurs

Lisa Heikes

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I'm hoping this is an easy question to get an answer for. It is Friday and I might have left my mind at home today.

Can 20552 be reported 2 times if in injected 1 x in each foot (heel).

THANKS
 

armen

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20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)

as you see code descriptions states single or multiple, so I guess no, you cant:)
 

ollielooya

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Armen, I've been trying to pull up some authoritative documentation, but since we're talking about two different extremities here which = separate sites, I'm thinking that the NCCI guidelines for allowance of modifier 59 would be applicable and that modifier 59 COULD be added, therefore 20552, 20552-59. Am open to correction or discussion here.
 

armen

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I see your point, but if we follow the same logic the for example:
CPT 11056 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions) should be billed twice if two lesions are on one side and 2 on different;

CPT 11720 (Debridement of nail(s) by any method(s); 1 to 5) should be billed twice if one tonail is debrided on each foot.

Same way you would be able to bill 20553 for one body part and 20552 for another if for example you had 2 muscles and 4 muscles injected on each side. This would not be possible to bill since CCI edits dont allow modifier to unbundle these two codes.

You can look up internet for specific guidelines. But as far as I know 20552 is per session code and should be billed once per day.
 
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