Wiki Spinal bursa injections

[ms.bones206]

I coded 3 levels of spinal bursa injections with Medicare insurance on 6/18/19 and 1/21/20, same patient, same dx and coded almost exact same way...the 6/18/19 was approved but the 1/21/20 only paid for one level. I have looked up and read just about anything I can get my hands on and I can't figure out why this happend. Denial code listed was denied as " duplicate" ***the only thing that was different is that the 6/18 had two dx and the 1/21 had one/and I added the 26 modifier to the 77002*** Below is how I coded them....

Any input or help from my fellow coders is appreciated. I have some more coming up to code and I do not want them to get denied.

6/18/20 - got paid
M96.1 Postlaminectomy syndrome, not elsewhere classified
M71.50 Other bursitis, not elsewhere classified, unspecified site

20605 LT
20605 59 LT
20695 59 LT
77002
99152

6/18/20 - only paid one level
M71.50 Other bursitis, not elsewhere classified, unspecified site

20605 LT
20695 59 LT
20695 59 LT
77002 26
99152

 

[Orthocoderpgu]

Medicare does not really like the -59 modifiers to break edits, they prefer the -X modifiers since it gives them more specificity. I would try using the -XS in this case.