ICD 10 Question

[elenipete]

Being a newbie in an orthopedic practice, I have a question for anyone who may want to answer it.

We often bill for injections. So How will I code a bilateral injection if the diagnosis does not have a bilateral ICD-10 code? would you still use 20610-50 with the 2 diagnosis codes (for left and right) or to save space, can you use the unspecified code?

Billing manager seems to think it redundant to use the modifier 50 and the 2 distinct codes. She wants to use the unspecified diagnosis code.

I was thinking the 50 is for the 2 units of the injection "and why do we need 2 injections?' because....... hence the 2 distinct codes.....

any help is always greatly appreciated!

 

[Alicia Scott]

I agree with you but am not an expert with CPT codes. When you have two seperate Dx codes then I think the -50 makes sense. Is there not a bilateral code for this? I am not near my CPT manual. Just moved you know.

 

[elenipete]

I agree with you but am not an expert with CPT codes. When you have two seperate Dx codes then I think the -50 makes sense. Is there not a bilateral code for this? I am not near my CPT manual. Just moved you know.

I wasn't speaking of any dx code in general, but for example, we often give injections for pain, and the dx is sometimes 923.00 contusion of the shoulder. In ICD-10 there is no bi-lateral code for contusion of shoulder just unspecified, left and right. So I was just wondering how this would work. Are we still going to have to attach LT or RT to the CPT code?

 

[Alicia Scott]

There is bi-lateral codes for contusion of the shoulder. 923.00 does not translate. Look at S40 codes.
S40 Superficial injury of shoulder and upper arm
S40.0 Contusion of shoulder and upper arm
S40.01 Contusion of shoulder
Code(s) Description
S40.011A ‑ S40.011S S40.011 Contusion of right shoulder
S40.012A ‑ S40.012S S40.012 Contusion of left shoulder
S40.019A ‑ S40.019S S40.019 Contusion of unspecified shoulder

 

[elenipete]

Hi!
Thanks!
But here is another question, the ICD 10 is so much more specific, we will still have to use LT or RT to the CPT code if the diagnosis states the side?

 

[Alicia Scott]

Yes that is true because they are two different code sets and have a different purpose. One does not speak for the other only gives the other value I guess you could say.

 

[elenipete]

Yes that is true because they are two different code sets and have a different purpose. One does not speak for the other only gives the other value I guess you could say.

Exactly!!!!!! Thank you Alicia!!! I just won the office bet!!!!

 

[Alicia Scott]

I hope they rewarded you with chocolate. That is what I would want. Invite them to the Q&A webinar Thursday. Then they can be as smart as you!
CCO Q&A Webinar - http://cco.pe/RE8m09