Podiatry Coding & Billing Alert

Question: My podiatrist inserted a needle through the patient’s skin and into an intermediate joint of their ankle. They used the syringe attachment to the needle to remove fluid. The provider also used ultrasound guidance with permanent recording and reporting to perform this service. Which CPT^® code should I report for this service?

Pennsylvania Subscriber

Answer: You should report 20606 (Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting). You should report 20606 only for joints or bursae of intermediate size, such as the temporomandibular joint, acromioclavicular joint, wrist, elbow, ankle, or the olecranon bursa.

Note: You should never report 20606 in conjunction with code 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation).

Arthrocentesis defined: Arthrocentesis relieves pain and swelling but is also a diagnostic aid, allowing the provider to examine the fluid in the joint, called synovial fluid, for the presence of infection or inflammation.