Does CPT code 20553 need a modifier?

Does CPT code 20553 need a modifier?

Key point to remember! – these 2 CPT Codes 20552, 20553 DO NOT NEED A MODIFIER!

Does CPT code 20552 include the medication?

Because this code specifies a number of muscles injected, not a particular amount of medication or number of injections, you’ll report 20552 because only two muscles (trapezius and levator scapulae) were injected.

Does 20610 and 20552 need a modifier?

Answer: You are correct, trigger point injection (20552 or 20553) and a joint injection, for example, a shoulder joint injection, (20610) are bundled by Medicare. You will note, however, that a modifier is allowed to override this edit.

Can CPT 20553 be billed alone?

The number of services for either code is one (1), regardless of the number of injections at any individual site, and regardless of the number of sites. Only 20552 or 20553 may be billed, not both. Trigger point injections must be billed on only one line, regardless of the number of sites.

Can CPT code 20553 be billed bilaterally?

Remember that these codes CPT 20552, 20553 are NOT billable as unilateral. Modifier 50 (bilateral) will NOT apply. Bill by the number of muscles!

Can 20552 be billed bilaterally?

How do I bill a CPT 20552?

For trigger point injections, use code 20552 for one or two muscle groups injected, or 20553 for three or more muscle groups. The number of services for either code is one (1), regardless of the number of injections at any individual site, and regardless of the number of sites.

How do I code 20553?

Effective March 1, 2017, Any combination of trigger point injections, CPT codes 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) and 20553 (Injection(s); single or multiple trigger point(s), 3 or more muscles), when billed >3 times in a 90-day period, for the same anatomic site, without …

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How is the CPT code 20552 selected?

Code selection is based on the number of muscles injected and not how many injections were given. Three injections were given into the right shoulder (no specific muscle noted). This is counted as 1 unit of 20552.

How many muscles are in 20552?

This is counted as 1 unit of 20552. Four injections into the right gluteus maximus and two into the right biceps femoris were administered is counted as two muscles or 20552. Trigger point injections were administered as follows: left deltoid x 4, left trapezius x3, and rhomboid minor x4 = three muscles or 20553 .

Is it appropriate to bill Medicare for non-covered services?

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier. Only one code from 20552 or 20553 should be reported on any particular day, no matter how many sites or regions are injected.

What is the CPT code for MOD modifier 50?

Modifier 50 should not be reported with CPT codes 20551, 20552, 20553 or 20612, but may be reported, when appropriate, with CPT codes 20550 and 20526. For an Ambulatory Surgical Center (ASC), the appropriate site modifier (RT and/or LT) should be appended to indicate if the service was performed unilaterally or bilaterally.