Wiki procedure 20610 different sites same day

[juneallegrezza]

We are coding for medicare. The provider performed joint injections bilaterally on the shoulders and the knees. We coded it as
20610 modifier 50 (for knees)
20610 modifier 50, 51 (for shoulders)

Medicare paid for the first line but denied the second line as - Payment adjusted because the payer deems the information submitted does not support this many services.
our diagnosis for the knees was on line 1 and diagnosis for the shoulder on line 2.

We previously submitted the second line with modifier 59 but that was denied as well.
Any suggestions on how we can get paid for the second line.

Thanks

 

[jtimothy]

Did you bill the second line at 20610 5059 previously or just 59? When I bill multiple bilateral joint injections, the first one would be just like you had - 20610 50- then the second large joint would be 20610 5059. The only time I've run across a denial with that is when the doctor uses the same dx code for all injections (I'm work for rheumatology). I hope that helps a little.

 

[amyjph]

Is it an MUE issue? Or, XS 59 possibly needed.

 

[Orthocoderpgu]

MUE is two.