Anesthesia Coding Alert
Document Digits for Tendon Injections
Question: How should I code tendon injections to both of the patient's thumbs and both third digits during the same visit? She is a Medicare patient.
Nebraska Subscriber
Answer: The correct injection code is 20550 (Injections[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar -fascia-]), but you also need to specify which joints the physician treated to distinguish the injections from each other. The CMS-1500 form allows you to document specific joints in Box 19, and some coders say including the designations with the procedure code helps clarify the procedure.
Report the third-digit injections as 20550-50 (Bilateral procedure) -F2 (Left hand, third digit) and 20550-50-F7 (Right hand, third digit).
Report the thumb injections as 20550-50-59- (Distinct procedural service) -F5 (Right hand, thumb) and 20550-50-59-FA (Left hand, thumb).
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