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Supartz injections

  1. #1
    Default Supartz injections
    Medical Coding Books
    I am having denials for supartz injections when bilateral injections are given. I am putting a 50 modifier on the second injection but being denied as a surgical procedure modifier. What modifier should I use?

  2. Default
    Well the carrier should be covering when you use a mod 50. My suggestion is either call the carrier and find out exactly why they are denying it or send the office notes with an appeal.

    Connie CPC

  3. #3
    Default
    Quote Originally Posted by dboutwell View Post
    I am having denials for supartz injections when bilateral injections are given. I am putting a 50 modifier on the second injection but being denied as a surgical procedure modifier. What modifier should I use?
    i would use RT & LT instead of 50. I had some problems with 50 before and I do not use it at all since then. RT LT is paying with no problems and it is easier to see if they are paying according to Fee schedule or not.

  4. Default
    Beware that some insurance companies do not accept RT or LT, like BCBS. When we get the denial we are sending the office notes with the appeal.

    Connie CPC

  5. #5
    Default
    Quote Originally Posted by dboutwell View Post
    I am having denials for supartz injections when bilateral injections are given. I am putting a 50 modifier on the second injection but being denied as a surgical procedure modifier. What modifier should I use?
    I'd make sure the carrier isn't actually paying both on one line at 150% of the allowable. We have had that come up in our office recently and only after doing an audit after one of my account reps said she had been doing lots of appeals we figured out that is what two of our carriers just started doing to us.

  6. Default Supartz
    For Correctly Billing Supartz Injections Bilaterally

    20610 x2 50 modifier
    J7321 x2 (no modifier)

    most insurances will also pay it billed
    20610 x1 RT
    20610 x1 LT,51
    J7321 X2
    Last edited by lovell2003; 02-07-2011 at 01:59 PM.

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