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HELP!

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mruiz12:
99215 MOD.25
J1020
J1030
20610
J7030
All of these were paid but i cannot get the insurance to pay pay for the iv
99360
99361
the insurance states it is bundled under cpt code 20610. I have all diagnosis codes where they need to go. I even at one point put a mod. 52 on the 96360. and they still denied. Can someone please help me. I don't know what else to do to get these paid.

kristin:
I am confused by the codes...

20610 is arthrocentesis/aspiration and injection.


Then you have 99360: "Code 99360 is used to report physician standby service that is requested by another physician and that involves prolonged physician attendance without direct (face-to-face) patient contact." Why would you bill this with a joint injection given in an outpatient setting?

And you have 99361, which is a deleted code, for a physician team conference. Again, why is this being billed?

Can you see why I am confused? Did you type out the wrong codes in your message?

mruiz12:
Sorry!, yes i did type out the wrong codes. They should be 96360 IV infusion 31 min to 1 hour and 96361 each additional hour.  :(

kristin:
Okay, I don't feel so confused now!  ;D

So let me see if I understand this patient encounter...they came in, had an office visit, had an IV infusion for hydration that went over one hour, and also had an arthrocentesis done on a major joint/bursa? And insurance is bundling the IV infusion for hydration into the arthrocentesis of a major joint/bursa?

mruiz12:
Yes

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