Pain Management Coding Alert

Question: How do you code for sinus tarsi injection?

Alabama Subscriber

Answer: Coding for a sinus tarsi injection is little challenging since the sinus tarsi is neither a joint nor a ligament — it is a space. The area is the soft indentation just in front of the lateral malleolus and contains nerve endings, fat, joint capsule, arterial anastomoses, and five ligaments.

You must identify the location where your physician has administered the injection. If your physician had administered an injection into the surrounding soft tissue you will code 20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar “fascia”]) while if it is in the actual sinus tarsi space, which provides the lateral access to the subtalar joint, then you can report using 20605 (Arthrocentesis, aspiration and/or injection, intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]; without ultrasound guidance).

Your diagnosis code should support the appropriate injection code. Report M77.50 (Other enthesopathy of unspecified foot) to report sinus tarsi syndrome.

Tip: Don’t forget to include a corresponding J code to get reimbursement for the drug your provider administered.