Orthopedic Coding Alert

Question: Our orthopedist documented "barbotage of a calcific density in the supraspinatus tendon" under fluoroscopic guidance. How should we report this barbotage procedure? Tennessee Subscriber Answer: If the physician documents barbotage, he most likely aspirated a site and then immediately injected the same site. You should report 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for this procedure, along with 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) for the fluoroscopy that the physician used. Although some coders erroneously report two units of 20610 for this service -- one unit for the aspiration and one unit for the injection -- you should code 20610 only once. Because its descriptor refers to "aspiration and/or injection," one unit of 20610 covers both the aspiration and the injection. -- You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.