Tips for Cpt code for arthrocentesis coding

Cpt code for arthrocentesis coding
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Procedure performed for Cpt code for arthrocentesis

The skin over the aspiration site is cleaned with an antiseptic liquid. The physician then pushes a needle through the skin and into the joint and then removes the fluid with the help of a syringe attached to the needle. After the aspiration, the fluid sample may be sent to the laboratory for further examination. Let check out the codes used for Cpt code for arthrocentesis.
For aspiration of intermediate joint (elbow, ankle etc.) report 20605 for small joint or major joint aspiration see 20600 and 20610.


Terminology used with Cpt code for arthrocentesis

Arthrocentesis, also known as joint aspiration, is the clinical procedure in which the synovial fluid from the space around a joint is removed using a needle and syringe.  In this procedure a local anesthetic is administered and the physician inserts a needle through the skin and into a joint or bursa. The fluid sample may be removed from the joint or a fluid may be injected for lavage or drug therapy. The needle is removed and pressure is applied to stop any bleeding. Mainly this procedure is used in the diagnosis of gout, arthritis and synovial infections. Joint aspiration is also helpful in relieving joint swelling and pain.

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 Clinical Scenario for Cpt code for arthrocentesis

Question:When our physician injects the lateral epicondyle, we report 20605. But someone recently told me that this is incorrect. How can it be the wrong code? The descriptor specifically mentions that the code refers to an elbow injection.

Answer: If the physicianinjects the lateral epicondyle, you should report 20551 (Injection[s]; single tendon origin/insertion). The lateral epicondyle is a tendon origin, not a bursa.

The descriptor for 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]) does refer to the elbow, but it also specifies a bursa or joint injection, which your physician did not perform.
If the physician documents an injection to the olecranon bursa (which is fairly close to the lateral epicondyle) you should bill 20605.

Reader Question: 20605 Is Right Size for AC Joint
Question: If the IR injects a patient's AC joint, should we report 20610? We're debating if that's the right code because the joint's in the shoulder.
Colorado Subscriber

Answer: For an injection to the acromioclavicular (AC) joint, you should report 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]).
Considering 20610 (... major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) is a common misstep for this type of injection because the AC joint is between the shoulder and the clavicle, and 20610's descriptor references the shoulder.
But 20605's descriptor specifically lists acromioclavicular, so you should report 20605 for AC joint injections by the interventional radiologist (IR).

Don't forget: You may report a code for guidance or radiology crosswalk separately. Choose from:
76942, Ultrasonic guidance for needle placement...
77002, Fluoroscopic guidance for needle placement...
77012, Computed tomography guidance for needle placement...
77021, Magnetic resonance guidance for needle placement.
Code selection depends on the size of the joint. When more than one procedure is performed on the same joint do not report separately. For aspiration or injection of a ganglion cyst, any locations see code 20612.

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