Wiki 20610 . or 27095

codedog

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Would this be 27095 or 20610, if its 27095 would it be because of the arthrogram ?

OPERATION: 1. Left intraarticular hip injection. 2. Fluoroscopic needle guidance.

ASSISTANT: None.
ANESTHESIA: 2% lidocaine 5 cc and sodium bicarbonate 8.4% 5 cc; monitored anesthesia care.
BLOOD LOSS: None.
FLUIDS GIVEN: 150 cc Lactated Ringer's solution.
URINE OUTPUT: None.
INJECTED MIXTURE: Depo-Medrol 80 mg, and preservative-free bupivacaine 0.5%, 4 ml.
PROCEDURE IN DETAIL:
Informed consent was obtained, explained the risks, benefits and alternatives of the procedure to the patient. Operative site was marked in the holding area. The patient was then taken to the procedure room and placed in the supine position on the procedure table. The skin was prepped with ChloraPrep solution and a sterile drape was applied. A time out was performed to verify the correct patient, procedure and laterality.
Using fluoroscopy, the hip was examined. The left femoral head on the right side was visualized. A skin wheal was raised in subcutaneous tissues and anesthetized with 2% lidocaine mixture. Using an anterolateral approach a 22-gauge 3.5 inch spinal needle was directed with intermittent fluoroscopic guidance into the left hip joint. Omnipaque 300 contrast approximately 1.5 mL was injected during live fluoroscopy. The arthrogram confirmed correct needle placement. There was no vascular uptake noted. After negative aspiration the injectate mixture was instilled through the needle. The needle was then removed from the skin.
A Band-Aid was placed over the skin entry sites. The patient was transferred to the recovery area. The patient was monitored for approximately 30 minutes and discharged after a normal neurologic exam. The patient was given postprocedure and discharge instructions. There were no apparent complications. The patient tolerated the procedure well.
 
20610 and 76000-tc
an arthrogram includes interpretation and documentation of results.
This does not appear to be the case as fluoro was only used to confirm position only.

Hope this helps
 
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