1. User id : 17647 Posted 2 years ago #
   

   Im wondering how to bill out for injection code 20550. Whether its bilateral or not, say we do 2 20550's. Do I need to bill each on seperate line items with modifiers? Or do I put 1 on a line item and change the unit to 2? Please help!!

2. SuperCoder Posted 2 years ago #
   

   1)Could you please give more information on which location you have injected the injection?
   2)If you are billing for medicare and if you are injecting on two different sites in the same operative session, then you could use 20550 first line to reimburse full payment and second line 20550-50 to reimburse 50% of the actual payment, other than medicare, you could use 20550x2. Hope this helps.

3. User id : 17647 Posted 2 years ago #
   

   Perfect! Now, does it make a difference if it is in two different sites, say one in the arm and one in the hip, verses doing bilateral arms?

4. User id : 17997 Posted 2 years ago #
   

   Since it is 2 different sites, I would bill 2 separate lines on the claim - such as 20550 and 20550-59 with 1 unit each on each claim line. The 59 mod will indicate a separate procedure/site, etc. Billing this way will get the claim processed correctly and no denial (unless there is another problem). When using Mod 50 on 1 line of the claim, the unit field will be 1 as the mod 50 indicates that is bilateral. But then you are paid one lump sum and sometimes you do not know if the claim was paid as a bilateral service or not. BUt when using 2 separate line entries, you see that both procedures are paid (the second usually at a reduced rate based on 2 surgical procedures on same day). I advised two separate line entries. Hope this helps.
   I get wordly sometimes, so I hope this is clear.

5. SuperCoder Posted 2 years ago #
   

   I am agree with Judy, but little clarification. 59 modifier could be used under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent. It should be used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual.

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