Anesthesia Coding Alert
Physician-Performed Shoulder Hydrodistention
Question: Our physician performs shoulder hydrodistention to treat adhesive capsulitis by injecting a chilled saline. What is the correct CPT® code, and does Medicare cover the service?
Hydrodistention usually is performed in conjunction with either physical therapy sessions or along with manipulation. Because an anesthesiologist performed the service instead of a physical therapist, submit 23700 (Manipulation under anesthesia, shoulder joint, including application of fixation apparatus [dislocation excluded]) for the care. Include 726.0 (Adhesive capsulitis of shoulder) as the associated diagnosis.
Virginia Subscriber
Answer: The saline injection is payable by Medicare and should be reported with 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]). Notice the guideline in CPT® directing you to see codes 76942, 77002, 77012, and 77021 if the provider uses imaging guidance.
Anesthesia Coding Alert
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