# AC Joint and Bicipital Groove Injections Help



## Melissa Harris CPC (May 6, 2014)

Hello,

Can someone help me code these two procedures??  I am not sure if the bicpital groove injection is the tendon sheath or the joint?



*PROCEDURE-Right Shoulder Bicipital Injection*


INDICATIONS: Shoulder Pain
Injectate: 1.5mL of 0.5% Marcaine and 0.5mL of 40mg/mL Kenalog
DESCRIPTION OF PROCEDURE:
 After informed consent was obtained, the patient was brought to the procedure room and placed on the procedure table in the supine position.  I then located the bicipital groove anteriorly to the shoulder by palpation.  I marked this groove and then cleanse the skin at my skin mark.  I advanced a 25-gauge 1/2 inch needle parallel to the bicipital groove at about 45? angle to the skin and once I felt as though the needle was in the bicipital groove, I injected the above injectate into the bicipital groove area and then remove the needle.  There were no complications.  A Band-Aid was placed on that injection site as well.

*PROCEDURE:  RIGHT ACROMIOCLAVICLAR JOINT INJECTION*

DESCRIPTION OF PROCEDURE:  After written informed consent was obtained, the patient was brought to the operating room and with appropriate monitors in place, the patient was placed in the supine position on the fluoroscopic operating room table.  The skin over the shoulder was prepped with Betadine and a 25 guage needle was advance downward into the center of the acromioclavicular joint where a mixture of  1.5mL of 0.5% Marcaine and 0.5mL of 40mg/mL Kenalog was injected.  The needle was then pushed forward so that it was below the acromioclavicular joint and into the bursa area and the remainder of the injectate was injected.  The needle was then removed and a Band-Aid was placed on the injection site.  The patient tolerated the procedure well and there were no complications.

Any help is greatly appreciated!

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management


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## fdeffendoll (May 6, 2014)

The bicipital groove is apart of the bone. I would say a joint injection


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## Sunny0967 (May 6, 2014)

I would use the 20610 as doctor states joint and bursa in note.


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## Michele Hannon (May 6, 2014)

The long head of the biceps tendon runs through the bicipital groove. It is a tendon sheath injection.


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