Anesthesia Coding Alert

Question: Our pain management specialist administered an injection to treat costochondral joint syndrome; he inserted the needle at the junction of the first rib and sternum until he contacted bone, then he injected Marcaine and Kenalog. This is not a joint injection, so how should I code the procedure? North Carolina Subscriber Answer: Because your provider placed the needle in the costochondral joint, some coders believe your best choice is 20600 (Arthrocentesis, aspiration and/or injection; small joint or bursa [e.g., fingers, toes]). Other sources, however, lean toward 20605 (... intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa]). The costochondral joint might be more similar in size to the joints represented by 20605, so ask your physician's advice on which is more accurate. Avoidance: Don't use 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscles) or 20553 (... single or multiple trigger point[s], 3 or [...]