10/10/2023

CMS Recoupment for Bilateral Injections-CPT 20600

I have received my first request for money back due to CMS guidelines regarding bilateral injections (20600) on a claim for BC/BS PPO DOS 09/26/2022. Is this correct? Thank you

The recoupment from Blue Cross is correct for bilateral services. These services cannot be billed on separate line items. A corrected claim needs to be rebilled for the two injections where one unit of service is billed appended with modifier -50. To be sure that the reimbursement is appropriate, the fee should be doubled for this specific claim, so the service is reimbursed at the correct rate.