Wiki Billing trigger point injection with joint injection

[judiism]

Hi there...

We have a new provider who performed trigger point injections (20550, 76942-59) on the same day as a joint injection (20611, J7320). Medicare denied the trigger point injection (20550) stating it cannot be performed/billed the same day as the joint injection. The other three codes were paid, however.

Is this is a problem with the way the procedures were coded/modifier issue? Or can we simply not perform these two procedures on the same day?

Thank you for your help!

 

[judiism]

To clarify:

This is how the codes were submitted:

20611-LT
J7320-LT
20550
76942-59

Thanks again!

 

[meghanhannus]

Modifier Issue

Hello judiism,

There is an edit with CPT 20611 and CPT 20550 it states that the codes can be billed together with a modifier. I recommend adding a modifier (51 or 59) to CPT 20550 and see if your claim gets paid.

Hope this helps~

M.Hannus, CPC, CPMA, CRC

 

[judiism]

Thank you so much for your help, Meghan!

Since I already have modifier 59 on code 76942 as it is used with 20550, will it be confusing to use modifier 59 on code 20550 to show it as being done at the same time as 20611?

I hope I'm not too confusing here!

Thank you!

judi

 

[meghanhannus]

Try modifier XS

Thank you so much for your help, Meghan!

Since I already have modifier 59 on code 76942 as it is used with 20550, will it be confusing to use modifier 59 on code 20550 to show it as being done at the same time as 20611?

I hope I'm not too confusing here!

Thank you!

judi

You're welcome~
No it will not be confusing as the modifier on 20550 will show separate procedure. You may also want to use modifier XS instead of modifier 59 to show same encounter and different anatomical site.

 

[judiism]

Thank you again! I will use the XS modifier.

 

[meghanhannus]

Thank you again! I will use the XS modifier.

Glad to be of help!