# 20550 or 20551



## avrilw (Jan 18, 2019)

Will someone tell me if this should be coded as 20550 or 20551 please? My guess is 20551 since he does not state it is in the sheath but just wanted to get clarification. Thanks


Problem # 1:  Dupuytren's contracture, right (ICD10-M72.0)

discussed options.  catching but not locking.  some pain but not really restricting him at his point.
elected to do kenalog injection.  area was prepped with betadine.  40mg of kenalog injected into nodularity in flexor tendon in mid palm.
tolerated well and reeval when necessary.


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## CICIB (Jan 23, 2019)

Did you look at 20527?  
Injection, enzyme (eg, collagenase), palmar fascial cord (ie, Dupuytren's contracture) 

and J3301 X 4 units


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## avrilw (Feb 1, 2019)

I did look at the 20527 but I don't think the  "enzyme (eg, collagenase)," is accurate. COLLAGENASE is an enzyme that breaks down collagen in damaged tissue and helps healthy tissue to grow. Kenalog is a corticosteroid....


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## dtricia (Feb 26, 2019)

*20550 and 20551*

I do not frequently bill for these codes. Can someone guide me to where it is written about billing drugs for these codes? I cannot see that you do.
Thanks,
Tricia D


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## Xieb (Feb 27, 2019)

Yes, you are right.
Based on the doctor's documentation, it is to be billed with 20551.

The hand contains flexor tendons and tendon sheats.
The information we have is injection specifically in the flexor tendon. 

CPT 20551 is for injections at the tendon origin or insertion. 
- The tendon origin is where the tendon attaches to the muscle proximally. Radiological guidance may be used to find the origin.
- The tendon insertion is where the tendon attaches to the bone distally.


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