# joint & bursa inj



## mattrobin (Mar 1, 2012)

If the Dr injects the patient's hip bursa, then the hip joint during the same encounter- can you bill 20610 twice?  or just once?


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## dwaldman (Mar 2, 2012)

When you look at the pictures of anatomy of ischial bursa, gluteal bursa, and trochanteric bursa they seem separate from the location of the hip joint.

When you look at psoas bursa or illiopectineal bursa, these structures are much closer to the hip joint and might be harder to support a separate injection from the anatomy pictures I was reviewing.

I think you would need two separate procedure notes that clearly show two separate injections: one into a bursa and one into joint and this would seem to support reporting of two codes. The descriptor for 20610 for example does say joint or bursa versus saying and/or.


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## kbarron (Mar 3, 2012)

Don't you need a modifier for these?


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## dwaldman (Mar 5, 2012)

If on the same side, billing multiple joint injection codes such as 20610 for example for right hip and right knee injection, WPS Medicare J5 had instructed me in the past to use 20610 x 2 RT instead of billing 20610 RT 20610 51 RT or 20610 RT 20610 59 RT. Other carriers might required different reporting.


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