Wiki Modifier 59 w/ injections - some injection claims


Greenville, SC
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I have an insurance company that is denying some injection claims. We billed 20610 for a shoulder injection and patient also had a trigger finger injection during the same visit which was billed 20550 (59). They want reasoning as to why the trigger finger injection should be paid. Is this not correct??? According to my coding companion, this should be payable. We're only having difficulty with one ins. co. with this.....Any help would be appreciated! Thanks!

Hi, Ollie,
My first and immediate question is did you send chart notes to show that the areas are different? If it is only one particular insurance companiy and you've having no problem with the others w/similar procedures, call and ask. IS the issue stemming from medical necessity? Suzanne E. Byrum CPC
I've had this issue before and the insurance company wanted only the shoulder dx linked to the shoulder injection and only the trigger finger dx linked to that injection.