Anesthesia Coding Alert

Technique Terminology:

Differentiate Arthrography And Fluoro for SI Injections

Both techniques have their place for confirmation, guidance

A physician can opt for either fluoroscopy or arthrography to help with confirmation and guidance before administering an SI joint injection. But do you know which is which? Here's a brief overview of each technique from Eileen Lorenco, RHIT, CS, CPC, a coder with Lahey Clinic in Burlington, Mass., to help you differentiate the two:
 

  • Arthrography is a special x-ray of the joint using multiple x-rays and fluoroscopy after the physician injects contrast into the joint. This contrast outlines the joint so the physician sees any scar tissue or unusual anatomy he should take into consideration. It is a formally interpreted contrast study and should be considered a diagnostic tool. A formal radiological report must be documented in the patient's record in order to bill for arthrography.
     
  • Fluoroscopy is an x-ray device that allows the physician to see the patient's anatomy on a video screen. The images are in real-time so the physician does not need to wait for a film to be developed. Fluoroscopies are sometimes called C-arms because of their wrap-around shape, and can also be used with contrast dye for better visualization of the joint. For documentation purposes, the physician only needs to state that he used fluoroscopy to confirm the needle placement prior to injection.
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