Wiki Billing Bilateral Sacroiliac Joint Injections

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HCOLLINS25

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I have a coder in my office that is saying we should be billing the SI bilateral injections to Medicare with G0260 with QTY 2 and no 50 modifier? For as long as I have been billing/coding we have billed bilateral Joint injections with the 50 modifier and QTY 1 and they were processed correctly. I am being told that they have recently changed the coding guidelines and the correct way is to bill with no modifier and QTY 2, Is this information correct or I am assuming our in office coder is trying to seek for more reimbursement instead and that is not correct. Any advice or info is appreciated. Thanks :)
 
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ASC facility claims (specialty 49) report bilateral procedures on two separate lines, with one unit each. Modifiers -LT and -RT are appended to each line. ASC facilities should not report modifier 50. Professional services performed in the ASC should continue to report bilateral procedures with modifier 50.
 
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HCOLLINS25 said:
I have a coder in my office that is saying we should be billing the SI bilateral injections to Medicare with G0260 with QTY 2 and no 50 modifier? For as long as I have been billing/coding we have billed bilateral Joint injections with the 50 modifier and QTY 1 and they were processed correctly. I am being told that they have recently changed the coding guidelines and the correct way is to bill with no modifier and QTY 2, Is this information correct or I am assuming our in office coder is trying to seek for more reimbursement instead and that is not correct. Any advice or info is appreciated. Thanks :)
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Hi there, if you're performing the injections in office you will not use G0260. It could be that your office coder is confused by the March update to SI joint interventions, so I wouldn't assume that they are just trying to get more money.
 
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