08/03/2017

Billing CPT Code 99212 Along With 20600 & 20550

Can you please explain to me how I should be billing for an office visit (99212) along with (20600 & 20550). No matter how I bill it, EXCELLUS doesn't seem to like it.

• The coding is medically necessary
• The linking is appropriate for the E&M, injections, and drugs billed

Our recommendation would be adding Modifier -59 on the unpaid injection. Modifier -51 (multiple procedures performed) should not have to be reported because most insurances account for the multiple surgery reduction when appropriate and when charges are processed for payment. By only reporting Modifier -51 and not -59, it does not indicate that one injection is being administered for plantar fasciitis and the other for osteoarthritis. If the corrected claim is still denied as bundled by Excellus, I would file an appeal with supporting documentation to prove that the injections were given for different conditions, both involving the patient’s left foot.