I have audited a hip injection (20610) performed in the hospital outpatient radiology department by an orthopedist with fluoroscopic guidance. The radiology department has added a charge for the permanent one view on file with CPT 73501. I am under the impression that this permanent image is for confirmation of needle position and, therefore, inclusive to the procedure. A 77002 was charged for the fluoroscopic guidance (correctly). Do any of you have a resource that explains this? I am writing my audit report and would like to present the findings with citations.
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Tag Archives: Arthrocentesis
Arthrocentesis vs Arthrotomy
Hello
My provider performed a right ankle arthrocentesis (20605) and right ankle arthrotomy (27620) during the same operation. CPT 27620 was the only code billed as there is a CCI edit between 27620 and 20605. The provider is saying that the arthrocentesis was performed in order to decide whether or not to perform the arthrotomy. He feels that 20605 should be coded and billed with a modifier 59.
Does the above scenario qualify as a ‘Distinct Procedural Service’ and does it justify appending modifier 59 to 20605?
Or would this be a diagnostic/surgical scenario? For instance, we wouldn’t code a diagnostic laparoscopy if performed in conjunction with a surgical laparoscopy..
Thanks in advance.
Arthrocentesis with EM Visit
I just started coding in an ortho office, my provider did an aspiration of a knee joint 20610 with an em visit that I coded to a 99213. Is it okay to code the em and procedure 99213-25, 20610?
Any advise is appreciated
Thanks
Coding Arthrocentesis, Aspiration, or Injection Is a Joint Effort
Utilize all the code sets, plus modifiers, to wholly capture physicians’ services. By Dawson Ballard, Jr., CPC, CPC-P, CEMC, CPMA, CRHC, CCS-P Coding for joint arthrocentesis, aspiration, or injection can be difficult, but following a few simple rules and pulling your coding resources together can make it easier. CPT® Categorizes Codes Arthrocentesis, aspiration, or injection […]
AAPC Knowledge Center
Failed to locate joint for arthrocentesis
Hi, has anyone came across coding for a failed arthrocentesis. The provider tried multiple attempts to aspirate the ankle joint but could not locate the needle into the joint. Would it be appropriate to assign 20605 with modifier 53 my concern is the needle never went into the joint. Thank you in advance for your assistance.
2016 – New CPT codes for Arthrocentesis
20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting
(Do not report 20600, 20604 in conjunction with 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)
20606 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting
20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting (Do not report 20610, 20611 in conjunction with 27370, 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)
The above three new codes (20604, 20606 and 20611) describe ultrasound imaging guidance as an inclusive component of arthrocentesis, aspiration and/or injection of a joint or bursa. Fluoroscopicguided arthrocentesis will remain component coded. Revisions were made to 20605 and 20610 to denote the procedures are performed without ultrasound guidance.