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20610 Modifier 50

  1. #1
    Default 20610 Modifier 50
    Medical Coding Books
    I have a question regarding billing for Aspiration/Injection (eg, shoulder, hip, knee joint, subacromial bursa). My office is confused on how to code for the following scenario to Medicare: Injection of right knee and right hip, same day injection of the left knee and left hip. How would we code this?
    20610-x 4
    According to an article I found on CMS the following would apply:
    "For procedure 20610, modifier 50 is appropriate when billing a bilateral injection only. Modifier 50 is usually not appropriate when billing a bilateral injection along with an injection in another body area. The correct billing of this scenario would be to list 20610 on one line of the CMS-1500 claim from with 3 indicated in the unit field. In situations where a provider performs bilateral injections (the right and left knee) and provides no other injections the bilateral services should be billed on one lien as 20610-50 with 1 unit."

    What does this mean do we bill the four units I am so confused also, if you have any direct website links that would help.

    thank you


  2. #2
    I would bill that scenario as follows

    20610-50 (dx 719.45)
    20610-50-59 (dx 719.46)

    BUT.. based on the article you quoted, it would seem that 20610x4 would also be appropriate. I wish I could be more help on this one...
    Walker Bachman, CPC, CPPM

  3. #3
    North Carolina
    This may be carrier specific. I would also bill as (based on my carrier)...


    ...along with the appropriate ICD-9 codes....

    Here's the entire article...

  4. #4
    I will check with our local carrier. Thanks

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