Radiology Coding Alert

Question: Should I report 10160 when the radiologist advances an 18-gauge needle into the suprapatellar bursa for aspiration? She used direct ultrasound visualization.

Vermont Subscriber

Answer: You should report 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for the aspiration. The suprapatellar bursa is a bursa (fluid-filled sac or cavity that prevents friction) between the lower thigh and quadriceps tendon, near the knee joint cavity.

Bursa aspiration code 20610, which specifies knee in the descriptor, is more accurate than 10160 (Puncture aspiration of abscess, hematoma, bulla or cyst).

Don't forget: A note with 20610 tells you to look to the following codes for imaging guidance:

• 76942 -- Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation

• 77002 -- Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device)

• 77012 -- Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation

• 77021 -- Magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection, or placement of localization device), radiological supervision and interpretation.

Your radiologist used ultrasound guidance, so you should report 76942.