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Billing Aetna injections with 20611 for ultrasound guidance.

Can anyone offer any insight on billing injections for Aetna with 20611 for ultrasound guidance? Aetna denies 20611 every time per their policy that it’s experimental. We have had some success with medical necessity on appeals, but Aetna Medicare has been denying this as well. Our sports medicine physician only does Orthovisc/Euflexxa injections with ultrasound. We are considering the option of billing the J code for the drug to Aetna and making the administration code self pay for the patient. Does anyone have any experience with this?

Medical Billing and Coding Forum

Coventry and 20611 denials

Has anyone else had issues with Coventry lately denying 20611 as not medically necessary per LCD? The only LCD I can find is for injections of the knee with hyaluronan. However, the ones that are denying are not being injected with hyaluronan and may be in any of the major joints, not just knees. We’ve tried appealing stating it is not related to the LCD, but denial was upheld. We are usually billing with a diagnosis of osteoarthritis for the related joint. Thoughts?

Thanks!

Medical Billing and Coding Forum

Provider billing 20611 with out image or separte report

Below I have pasted the procedure note from document. This is all that is being report with the US guidance. We fell the 20611 is correct and the code he should be using is the 20610. Any advice please even if you agree is helpful. Again there is no image of the US in the chart. Provider thinks as long as its stored in the US machine he doesn’t need to print out and have the image imported into the patients chart.

Procedures:
Procedure: Left Intra-articular Hip Joint Injection with Ultrasound Guidance
The procedure, alternate treatment options, risks and benefits were explained to the patient and informed consent was obtained. Bony landmarks, femoral vessels and joint space were identified using the ultrasound device. The area was prepped in the usual sterile fashion with betadine. Local anesthesia achieved using Ethyl Chloride spray. Lidocaine 1% without epinephrine (10mL) and Dexamethasone 8mg was injected into the joint using a 22g spinal needle (3.5”) from an anterior approach under ultrasound guidance.

EBL: Less than 5mL

Patient was given standard post procedure instructions and return precautions given. The patient tolerated the procedure well without complications.

Thank you

Medical Billing and Coding Forum

Wiki Prp injection with injection 20611

I came across an account where the surgeon billed for a PRP injection and also for 20611 inj/aspiration but chart note does not indicate reason for 20611-injection. I was told by charge entry that provider bills for administering the prp injection and that 20611 is for the administration. Is there a code we can bill for administering a PRP injection? I know 20611 is not the correct code to use….??

Medical Billing and Coding Forum