Ask Dr. Z

Dr. Z, Good morning! Radiologist will dictate "Left L5-S1 interlaminar epidural steroid injection", I charge 77003/62311. Radiologist dictates "Bilateral S1-2 interlaminar epidural steroid injection", I charge 77003/62311-50. I spoke to my radiologist, he says usally it is a bilateral injection, but ocassionally if the patient has had previous surgery or injury only one side is done. I asked that a bilateral charge be built in our chargemaster for the bilateral injections. They are getting challenged with this request, they say this code should not have a 50 modifier. What are your thoughts on this issue? I thought I was doing the charges correctly, no edits, but now the challenge from the the charge master software auditor. In your Interventional Radiology Coding book I find that 50 modiifers are to be used for the facet joints/64493, page 451, and nerve root blocks/64483, page 455. So I need help with the Epidural Injections. As always, thank you for your help, R Mercer