Forum - Questions & Answers

Jun 21st, 2011 - cforsthoefel 10 

bilateral joint injection, shoulders both injected

Both rt and lt shoulder injected on the same day.Do we use 20610 twicewith modifier 50 on one line to show both injections? Or use 20610 only once and change the units to "2"? Also need lt and rt modifiers? Not sure there is a place for both the 50 and lt/rt/ modifiers on our billing screen. So what is the best way to do this?

0 Votes - Sign in to vote or reply.
Jun 21st, 2011 - jschmutz   323 

re: bilateral joint injection, shoulders both injected

Check with your payer. Most Medicare payers now want it billed on two lines with the RT/LT modifier.

1. 20610-RT (1 unit)
2. 20610-LT (1 unit)

0 Votes - Sign in to vote or reply.
Jun 21st, 2011 - ziaclarkson 30 

re: bilateral joint injection, shoulders both injected

Depending on the payer :

20610-50 with 1 unit at 1.5x your typical fee

or

20610-RT with 1 unit at your fee
20610-LT with 1 unit at your fee

Different payers prefer it presented differently.

0 Votes - Sign in to vote or reply.
Jun 22nd, 2011 - DebraS   67 

re: bilateral joint injection, shoulders both injected

When a procedure code is done bilaterally, how many units are billed?

If an individual procedure is identified by the CPT® terminology as being "bilateral" or "bilateral or unilateral" do not report modifier 50. If an individual procedure is not identified by the CPT® terminology in the above manner, the bilateral procedure would be listed on one line with the 50 modifier and a unit value of "1" or "0010" in the Days/Units field.

February, 2008 - Reviewed April 2011

https://www.cahabagba.com/part_b/education_and_outreach/faq_coding.htm
--------------------------------------------------------
Note that it says a unit (value) of 1. If your charge amt is not more than 150% of the fee schedule itself then you need to re-evaluate your charges. We do not change the value amt on the one line item/value for MC. Other payors Lt/Rt and a few others are 2 units/-50 mod. You can look up their bilateral policies on their websites or call. Some sites have a search and you can then just type in bilateral billing or something to that effect.

0 Votes - Sign in to vote or reply.


Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2021 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association