Neurology & Pain Management Coding Alert

Here’s why ICD-10 smarts are key for these 3 injection services.

When you’re coding in a PM practice, you’re going to see your share of claims with injection services to ameliorate a patient’s pain or treat an injury. One of the most frequent shots you’ll see for patients is the tendon sheath/ligament injection.

During a Virtual HEALTHCON 2020 session, Nate Felt, MS, ATC, PTA, CPC, of Intermountain Medical Group, took attendees through how to code for this very common PM service.

Check out a bit of what they got to learn during Felt’s session.

Shot Called for Hundreds of Conditions

One of the most common injection procedures you’re likely to see is the tendon sheath/ligament shot, which is commonly used to treat conditions like trigger finger, tennis elbow, Achilles tendonisis, and distal bicep tendonitis, said Felt. You’ll report this service with 20550 (Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia”)).

Chalk up this injection’s frequency to its versatility; your provider can perform it on any tendon sheath in the body. A tendon sheath, Felt reminded, “is a layer of synovial membrane around a tendon. It permits the tendon to stretch and not adhere to the surrounding fascia.” So, any tendons in any anatomical area are potential 20550 targets.

One Local Coverage Determination (LCD) reports more than 500 ICD-10 codes that are approved for 20550, among them:

• M25.3XX (Other instability of joint)
• M75.2X (Bicipital tendinitis)
• M76.0X (Gluteal tendinitis)
• M76.3X (Iliotibial band syndrome)
• M76.6X (Achilles tendinitis)
• M76.7X (Peroneal tendinitis)
• M77.0X (Medial epicondylitis)
• M77.1X (Lateral epicondylitis)

Note: This is not a definitive list. Check your LCDs for to discover acceptable diagnoses for 20550.