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Bilateral 20551 into elbows

Karen Posted Tue 04th of August, 2015 12:02:16 PM

We have billed for each elbow, on line one: 20551 Lt
line two: 20551 59 Rt
(This procedure code has an MUE of 5 also)
The payer is United Healthcare and they state they will only pay 100 of 20551 and they will not allow 150%. Does anyone else have trouble?

SuperCoder Answered Wed 05th of August, 2015 01:40:24 AM

Bill the other unit with -51 modifier. Ideally, the insurance should pay 150% in total. Please make sure, you are providing sufficient documentation stating that procedure was done bilaterally. If still not getting paid, Please put this case for appeal.

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