# January >= Codes



## dwaldman (Sep 16, 2014)

20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance

20604 with ultrasound guidance, with permanent recording and reporting

(Do not report  20600, 20604 in conjunction with 76942)

(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

20605 Arthrocentesis, aspiration, and/or injection, intermediate joint or bursa (eg, temporomandibular, acormioclavicular, wrist, elbow, or ankle, olecranon bursa); without ultrasound guidance

20606 with ultrasound guidance, with permanent recording and reporting 

(Do not report 20605, 20606 in conjunction with 76942)

(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder hip, knee, subacromial bursa); without ultrasound guidance

20611 with ultrasound guidance, with permanent recording and reporting


Do not report 20610, 20611 in conjunction with 76942)
(If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

22510 Percutaneous Vertebroplasty (bone biopsy included when performed) 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance, cervicothoracic

22511 lumbosacral

22512 each additional cervothroacic or lumbosacral, vertebral body (List separately in addition to code for primary procedure)

(Use 22512 in conjunction with  22510, 22511)

(Do not report 22510, 22511, 22512 in conjunction with 20225, 22310, 22325, 22327 when performed at the same level as 22510, 22511, 22512_

225213 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included with performed) using mechanical device (eg, Kyphoplasty) 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance

22514 lumbar

22515 each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)

(Use  22515 in conjunction with 22513, 22514)

(Do not report 22513, 22514, 22515 in conjunction with 20225, 22310, 22315, 22325, 22327 when performed at the same level as 22513, 22514 ,22515)

62284 Injection procedure for myelography and/or computed tomography, lumbar (other than C1-C2 and posterior fosa)

(Do not report  62284 in conjunction with 62302,62303,62304, 62305, 72240, 72255, 72265, 77270)

62302 Myleography via lumbar injection, including radiological supervision and interpretation; cervical

62303 thoracic

62304 lumbosacral

62305 2 or more regions (eg lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)

76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, location device,), imaging supervision and interpretation

(Do not report 76942 in conjunction with 10030, 19083, 19285, 20604, 20606, 20611, 27096, 322554, 32555, 32556, 32557, 37760, 37761, 43232, 43237, 43242, 45341, 45342, 64479-64484, 64490-64495, 76972, 2013T-0218T, 0228T-0231T, 0232T , 0249T, 0301T)

72265 Myleography, lumbosacral, radiological supervision and interpretation

(When both 62284 and 72265 are performed by the same physician or other qualified health care professional for lumbosacral myelography, use 62304)

Presumptive Drug Class Screening

80300 Drug screen, any number of drug classes from Drug Class List A, any number of non-TLC devices or procedures (eg, immunoassay) capable of being read by direct optical observation, including instrumented-assisted with performed (eg, dipsticks, cups, cards ,cartirdiges) per date of service


80301 single drug class method, by instrumented test systems, (eg, discrete multichannel chemistry analyzers utilizing immunoassay or enzyme assay), per date of service

80302 Drug screen presumptive, single drug class from Drug Class List B, by immunoassay (eg, ELSIA) or non-TLC chromography without mass spectrometry (eg, GC, HPLC), each procedure 

80303 Drug screen, any number of drug classes persumtive, single or mutple drug class method; thin layer chromatography procedure(s) (TLC) (eg, acid, neutral alkaloid plate)per date of service

80304 not otherwise specified presumptive procedures (eg, TOF, MALDI, LDTD, DESI, DART) each procedure


Definitive Drug Testing

(Use 80320-80377 to report definitive drug class procedures. Definitive testing may be qualitative, quantitative, or a combination of qualitative and quantitative for the same patient on the same date of service


82541 Column chromathography/mass spectrometry (eg GC/MS or HPLC/MS) non-drug anaylte not elsewhere specified qualitative single stionary and mobile phase


82542

82543

82544


(For column chromatography/mass spectrometry fof drugs or substances, see Drug Assay 80300, 80301 ,80302 80303 80304 80320-80377 or specific analyte code(s) in the Chemsitry section.


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## skweston (Sep 17, 2014)

So for 20611 bursa injection with ultrasound guidance with permanent recording and reporting what do you think that means exactly?  I know when the physician does a  bursa injection with ultrasound he takes an image and records that in the note  is that going to be enough  ?

Also do you think CMS will keep the G0434 drug screening code or will they change it to reflect the new CPT codes for drug screening ? How long do you think it will be before the insurance companies are on board with these updated codes?  

The drug screening codes so far have been  a pain for my office considering that the insurance companies never really went along with the last change in regards to quantitative drug screens done in office particularly the 80104... Some of them eventually went with the G0434 but our problem still arises with the state Medicaid not accepting either code so now that the codes are changing again my fear is that the State especially  is not going to update their fee schedule yet again to reflect the new codes so my provider will still not get paid for the urine drug screens done in office.

Any suggestions? 

Thank you!


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## dwaldman (Sep 17, 2014)

?Permanent recording and reporting (recording requires the permanent storage of images, reporting requires the documentation of permanent images obtained in the procedures report)

?Notation of anatomic landmarks
?Notation of visualization of needle
?Retention of permanent images

I saw the above from Mary Jo Gross, CANPC, CPC National Coding Manager ? Anesthesia McKesson Revenue Management Solutions and Courtney Hanna, CHC, CPC Compliance Program Director ? Anesthesia McKesson Revenue Management Solutions. I thought it was a good description so I copy and pasted. The full article can be found

http://anesthesiology.mckessonreven...ure-documentation-and-ultrasound-guidance-qaa


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In regards to the drug testing codes, I believe there will be challenges with a new code set that has been presented, but I hope the end result  will prove to be better equally for the provider and the payer.


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## skweston (Sep 18, 2014)

Thank you for that information.. my provider is currently doing that I just wanted to make sure nothing extra needed to be notated 

In regards to the urine drug screening, I hope that the end result will prove to be better for the provider and payer because up to this point it has been a huge pain for those providers who accept Medicaid in the State of Florida.

I truly hope the State will FINALLY make the appropriate changes to their lab fee schedules because as of right now the only urine drug screen CPT codes they have is 80100, 80101 and 80102 none of which are acceptable to use for point of care testing by CLIA waived test.

So in other words my provider has not been getting paid on the CLIA waived point of care urine drug screens in office that the State of Florida requires for pain management clinics.

No one that I have talked to seems to have the slightest clue about anything and frustration has ensued 

Somebody somewhere has to know something!? 

If you or maybe you know someone that could point me in the right direction.. I am seriously contemplating contacting my Congressman to push for the State to make the appropriate changes.

I do not know of anything else I can do?? I have posted in several forums and I can't find anyone who is familiar with Florida Medicaid and who might be having the same issue?

Thank you!


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