Brenda Posted Thu 19th of July, 2012 15:50:46 PM
I have a pt who received multiple costochondral joint injections, that is 5 on her first visit, and 6 on her second visit. I believe the codes to use would be 20600 or 20605 but since I have 5 and 6 of the same injections on each visit do I need a modifier to indicate the different locations and procedures? They are all on the left side of the body. Would I be correct in using modifer 51?
Thanks for any insight.
SuperCoder Answered Fri 20th of July, 2012 00:48:11 AM
Because your provider placed the needle in the costochondral joint, some coders believe your best choice is 20600 (Arthrocentesis, aspiration and/or injection; small joint or bursa [e.g., fingers, toes]). Other sources, however, lean toward 20605 (… intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa]). The costochondral joint might be more similar in size to the joints represented by 20605, so ask your physician’s advice on which is more accurate.
You can represent multiple injections with a 59 modifier.The 51 modifier is basically letting the carrier know there are more than one procedure (multiple procedures performed) (not used in some settings, depends on who you are billing for)
The 59 modifier is to let the carrier know its a separately identifiable different location/site. (trying to sum this up but this one can be much more complicated)