# manipulation fingers



## scooter1 (Dec 17, 2013)

Doctor  performed an endoscopic carpal tunnel and also a PIP joint manipulation with 20 mg Kenalog injection.  He wants to charge 29848,  26340  and 20600.
I know the 29848 is correct and also the 26340 for manipulation. My question is can we
charge the 20600 ? I would think that would be bundled with the manipulation. I have not
coded separately for that in the past. . . .  the report reads :
PIP joints were very stiff. Using a 27- gauge needle, 20 mg of Kenalog was injected into the left index finger PIP joint, and left long finger PIP joint. After injections were performed, the medication was allowed to sit for short time, and the fingers were then manipulated, getting some lysis of adhesions of the joint. I was able to get his PIP joints flexed to about 100 degrees when completed.

Please help ?


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## aalley (Dec 20, 2013)

For CPT code 26340 The Complete Global Service Data Book states "local infiltration of medication(s), anesthetic, or contrast agent before, during, or at the conclusion of an operation" is included.  I don't bill separately for it because of this statement.  I hope this is helpful.


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## scooter1 (Jan 2, 2014)

I figured it was include, too.  Thank you for verifying


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