20610

Hi,
Hope that some one can help me with this matter.

We sent a claim to the insurance.
And insurance denied it. CPT® code; 99213,20610-25 and J3301.
DX CODES are: 715.16-primary ostheoarthrosis of knee and 992.1--heat syncope(DOS: 12/08/11)

According to the insurance its still on global period. But patient never had sugery in the past he was last seen 9/27/11 with DX: V70.9, 992.1, 706.1, 530.81.
he was new that time so we billed 99203 as e/m code

My question is what is wrong with the billing done to this patient for DOS: 12/08/11?

Thank you...

Jan 25th, 2012 - ziaclarkson 30

re: 20610

Should be : 99213-25 w dx 992.1

Jan 25th, 2012 - ziaclarkson 30

re: 20610

wow my message was much longer but did not transmit completely.

Jan 25th, 2012 - ziaclarkson 30

re: 20610

this requires also 20610- RT or LT depending on the side of the body.

Did the patient have any other knee injections recently ?

Jan 25th, 2012 - rhina 52

re: 20610

Thanks, Can we use modifier 50 , patient was injected on his both knees.
No injections done on his first visit.

Jan 25th, 2012 - ziaclarkson 30

re: 20610

bilateral... well, yes you can use 20610-50 one unit, price 1.5x your fee schedule. or you can bill RT and LT. Different payers require different presentations. Just an FYI on that. :) Good luck.

Jan 25th, 2012 - rhina 52

re: 20610

Thank you much...
That gives me another pointer to remember. So when I encounter same information I can used the procedure..
thanks again