Orthopedic Coding Alert

Question: The physician used our X-ray equipment in the office to place the needle prior to a hip injection. He did not use the C-arm or what I would consider fluoroscopy for additional guidance. Someone suggested we include modifier 26 on the claim, but I disagree. Who's right?

New Hampshire Subscriber

Answer: You are correct: If your office owns the guidance equipment, you shouldn't append modifier 26 (Professional component) to the guidance code. Report the service X-ray with 73500 (Radiologic examination, hip, unilateral; 1 view) or 73510 (... complete, minimum 2 views), depending on the number of views. Include 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for the injection itself.