Orthopedic Coding Alert

Question: My physician performed ultrasound guidance for aspiration. What does this involve? Should I report it with 76942 and 20600-20610? South Carolina Subscriber Answer: You should be fine reporting 20600-20610 (Arthrocentesis, aspiration and/or injection -) with 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation). Make sure you have the appropriate documentation to support your codes. Remember: You should apply modifier 26 (Professional services) if your physician performed 76942 in a facility setting. Hip injections often require as much precision as sacroiliac injections, and, therefore, physicians frequently use fluoroscopy to identify the site correctly. In fact, a comment in CPT following codes 20600-20610 advises, "If imaging guidance is performed, see": - 77002 -- Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device) - 77021 -- Magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection, or placement of localization device), radiological supervision and interpretation - 76942.