Injection Code 20550

  When I submit CPT code 20550, “Injections; tendon sheath, ligament” for different sites injected on the same date, should I attach modifier -51, “Multiple procedures,” so that a multiple procedure rate reduction may apply to the second, third or any additional sites injected?

According to CPT, 20550 is not exempt from modifier -51. Likewise, the Medicare Fee Schedule database indicates that this code is subject to the standard payment adjustment rules for multiple procedures. To make it clear that injections were done at different sites, submit 20550 for the first site injected and 20550 with modifier -59 (to show that a different site was injected) and modifier -51 (to indicate multiple procedures were performed) for subsequent injection sites. Linking appropriate diagnosis codes to each instance of 20550 may also make it clear that the injections were done at different sites.

Editor’s note: While this department attempts to provide accurate information and useful advice, third-party payers may not accept the coding and documentation recommended. You should refer to the current CPT and ICD-9 manuals and the “Documentation Guidelines for Evaluation and Management Services” for the most detailed and up-to-date information.