01/16/2019

Billing for Injecting Bilateral 1st MP Joint for Hallux Limitus/Rigidus

I injected the bilateral 1st MP joint for hallux limitus/rigidus. Dx: M20.20 and M12.879. How is this billed?20600/50?

For bilateral injections, the services can be billed in one of two ways:

If the insurance requires one line to be billed for a bilateral service:

• Bill one line item and one unit with CPT code 20600 (arthrocentesis, aspiration and/or injection; small joint or bursa)
• Double your fee
• Append modifier -50 as the primary modifier to indicate a bilateral service
• Bill four diagnosis codes for the one service line:
• M12.872: Other specific arthropathies, not elsewhere classified, left ankle and foot
• M12.871: Other specific arthropathies, not elsewhere classified, right ankle and foot
• M20.22: Hallux rigidus, left foot
• M20.21: Hallux rigidus, right foot

If the insurance requires two lines to be billed for a bilateral service:

• Bill two line items with CPT code 20600 (arthrocentesis, aspiration and/or injection; small joint or bursa)
• Append modifier -LT as the primary modifier on one line, and -RT to the other to indicate a bilateral service
• Bill two diagnosis codes per service line based on the laterality of the ICD code one service line:
• For the left sided injections:
• M12.872: Other specific arthropathies, not elsewhere classified, left ankle and foot
• M20.22: Hallux rigidus, left foot
• For the right sided injections:
• M12.871: Other specific arthropathies, not elsewhere classified, right ankle and foot
• M20.21: Hallux rigidus, right foot