Ingrid Posted Wed 28th of September, 2016 10:56:41 AM
I've recently been receiving insurance denials for 1 unit of 20527 (Dupuytren's injection) and 1 unit of the manipulation code 26341 when billing for 2 units. Has there been a recent change in the units allowed?
SuperCoder Answered Thu 29th of September, 2016 02:43:00 AM
Hi, please share the exact reason for denial and any other specific case related details which reflect the reason for denial. Thank you.
Ingrid Posted Thu 29th of September, 2016 19:33:37 PM
Injection was performed over the cord of the right ring finger and the cord of the right small finger. Denial states: The number of Days or units of service exceeds our acceptable maximum. One injection was paid and the other had this denial reason.
They also did the same thing to the manipulation (26341). Both cords were manipulated. One paid the other denied. Thanks for your help!!
SuperCoder Answered Fri 30th of September, 2016 07:06:48 AM
Following is some billing related information for the two codes 20527 and 26341:
Code 20527 should be reported only once for the enzyme collagenase injection(s) into a single palmar fascial cord even if more than one injection is performed in a single cord. For example, when a contracted fascial cord is injected with the enzyme in 3 separate but close locations, 20527 is reported once. If the patient has injections in more than one cord, 20527 should be reported for each cord with modifier 59 for the subsequent cords.
Code 26341 is reported for the manipulation of the palmar fascial cord performed on a day subsequent to the enzyme injection(s). Code 26341 includes the manipulation of a single cord. If in case more than one cord is treated, code 26341 should be reported for each cord with modifier 59 for the subsequent cords.
Hope this helps. Thank you.