Radiology Coding Alert
Don't Consider Unbundling Modifier for Elbow, Shoulder Aspiration Codes
Question: Our provider performed an aspiration of the right shoulder and left elbow. Ultrasound guidance was only used for the shoulder aspiration. Can I bill these procedures together without a modifier? If so, what CPT® codes do I apply? Texas Subscriber Answer: Since CPT® has implemented aspiration/injection/arthrocentesis codes that include ultrasound guidance, you should not consider the use of separate ultrasound guidance code 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation). Additionally, you may bill these two procedures separately without an unbundling modifier. You should apply code 20611 (Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting) for the shoulder aspiration with an RT (Right side) modifier appended. For the elbow aspiration, you will apply code 20605 (Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance) with an LT (Left side) modifier appended.
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