# arthrogram injection left hip



## gladys font (Sep 28, 2010)

Before I bring this situation up to the physician.  I need your input on this matter.
According to Office protocol this report was coded by a coder as 27093, 77002 and A4550.

Insurance denied pmt on 77002.  Should this have been billed as 27095, 73525  or keep it as 27093 and change 77002 to 73525?

Clinical Indication Hip Pain
Fluoroscopy time 51 seconds

Utilizing sterile technique and after adequate local anesthesia was obtained, a 20gauge needle was introduced into the left hip joint.  Approx 13cc of dilute Magnevist and Isovue 300 were injected.  A radiographic image was obtained for documentation and asssessment.  The image demonstrates intra-articular contrast which is unremarkable in appearance with the exception of a small droplet of air projecting over the mid femoral neck.  The patient was transferred to the MRI scanner where multisequence multiplanar imaging will beperformed.

Thank you for your help.


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## capgrl79 (Sep 28, 2010)

Because the report states A radiographic image was obtained for documentation and asssessment. The image demonstrates intra-articular contrast which is unremarkable in appearance with the exception of a small droplet of air projecting over the mid femoral neck, I would code the 73525 instead of 77002 based on the cpt definition of 73525.


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## L_Silva CPC (Sep 28, 2010)

Actually, if you have Dr Z's book, on page 401 #3 it states that one or two images at injection time does not constitute an arthrogram; therefore only fluoroscopic guidance should be coded instead of the diagnostic arthrogram SI code.


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## AForeman (Oct 1, 2010)

I would code 73525  and 27093.


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