# Pubic symphysis injection-sterile fashion



## ortho1991 (Aug 15, 2012)

Hi All,

I hope someone can help with this code.

The patient was prepped and in sterile fashion.  Using fluoroscopic guidand in the AP view, the pubic symphysis was visualized. Suboutaneous injection of 1% lidocaine was done at the area of entry.  Thereafter, a 1-1/2 inch 22 gage spinal needle was directed into the joint, confirmation was made with radiopaque dye approximately 0.5 ml. Then, a total of 20 mg Kenalog and 1.5 ml of 1% lidacaine was injected.

Any help with this will be appreicated.

Thank you


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## dwaldman (Aug 15, 2012)

"The pubic symphysis is a cartilaginous joint that forms the median junction of the two pubic bones. This symphyseal joint consists of the fibrocartilaginous interpubic disc, the superior pubic ligament, and the arcuate pubic ligament. This solid connective tissue joint has limited mobility and forms the strong anterior connection between the two os coxae."

http://www.anatomyexpert.com/structure_detail/15652/921/


The joint portion was injected per the procedure note instead of the ligament (20550) so I would use either 20600 or 20605. Could query the physician if he feels the joint is an intermediate (similiar to the AC joint, wrist , elbow) or a small joint (fingers or toes). I couldn't tell from the illustration  they provided which to lean towards.


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