Radiology Coding Alert

Question: If the IR injects a patient's AC joint, should we report 20610? We're debating if that's the right code because the joint's in the shoulder.

Colorado Subscriber

Answer: For an injection to the acromioclavicular (AC) joint, you should report 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]).

Considering 20610 (... major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) is a common misstep for this type of injection because the AC joint is between the shoulder and the clavicle, and 20610's descriptor references the shoulder.

But 20605's descriptor specifically lists acromioclavicular, so you should report 20605 for AC joint injections by the interventional radiologist (IR).

Don't forget: You may report a code for guidance separately. Choose from:

• 76942, Ultrasonic guidance for needle placement ...
• 77002, Fluoroscopic guidance for needle placement ...
• 77012, Computed tomography guidance for needle placement ...
• 77021, Magnetic resonance guidance for needle placement ...