Orthopedic Coding Alert

Question: Our surgeon performed arthroscopic surgery on a patient's left knee. During the postoperative global period, the patient came in and requested a steroid in-jection into her left knee to alleviate pain. The orthopedist circled 20610 on his super-bill and linked it to diagnosis 715.16. Does the global period include the injection?

Arkansas Subscriber Answer: You should append modifier -79 (Unrelated procedure or service by the same physician during the postoperative period) to 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for the injection. The physician linked the injection to the ICD-9 code 715.16 (Osteoarthrosis, localized, primary; lower leg), so he performed the injection to alleviate arthritis pain rather than postoperative pain. Therefore, your payer should not include the joint injection in payment for the surgery.