# Determining what joint



## swillard (Nov 22, 2011)

what is considered to be a small joint, and what is an intermediate joint?  We did an MCP joint injection. medium joint?


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## jdemar (Nov 22, 2011)

20600 is for hand, carpal, metacarpal and phalanges.  (*small *joint or bursa (finger, toes).
20605 is for wrist, elbow, ankle, olecranon bursa.    (i*ntermediate* joint or bursa, etc...
20610 is for shoulder, hip, knee joint and subacromial bursa. (*major* joint, bursa, etc....


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## swillard (Nov 22, 2011)

I had thought the only small joints were the IP & DIP joints


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## jdemar (Nov 22, 2011)

info from 2009 Decicion Health/ www.ortho-decisions.com (Orthopedic Coder's Pink Sheet)......support is relating back to the DX digit ....since intermediate injec code 20605 lists wrist............ and the carpals and metacarpus are listed separately in the same grouping as the hand and fingers, that appears t support that a carpaometacarpal injec is  1. separate from the wrist joint and 2. considered a small joint injection 20600.
DX 719.4*3*
DX 714.4*4*....anatomical area........is the fifth digit

have a HAPPY THANKSGIVING....I'll be back Monday....hope this helps.


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## swillard (Nov 22, 2011)

you don't put a modifier on carpal bones though, on the IP & DIP joints.  this could be another indicator.  Not to say you are incorrect, but looking at that link, it just tells me that the carpal bones are a part of the hand, it doesn't indicate to me what size of joint it is.


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