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Coding Question, Please help

  1. Question Coding Question, Please help
    Clearnace Sale
    Can I code for a synvisc injection in the right knee and a synvisc injection in the left knee on the same day for the same patient and put a lt and rt as the modifier with the cpt code for a medicare patient and his secondary is tricare for life? Please help. Will I get reimbursed for the full allowable on both knees?

  2. #2
    you can bill with rt and lt but as far as i have seen medicare goes by 100/50/50 rule
    Angelica Stephens RHIT, CPMA, COSC, CCS-P, CPC, COC.
    Albuquerque, NM

  3. Default
    the 100/50/50 rule applies to the injection code only. the j code will not be reduced

    for mcr bill 20610 50
    J7325 with 32 units

    for bc/bs bill 20610 11
    20610 12
    J7325 32

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