amexnikki23
Guest
Hi. A group of us has been going back and forth on this for what seems like forever. Here is the scenario (which contains sub-scenarios).
Patient having steroid injection in major joint (we'll go with the knee for purposes of all being on the same page).
- Provider performs an arthrogram to evaluate contrast/needle placement
- Injects contrast for the arthrogram
- Fluoroscopy for the athrogram
- Injects steroid into the knee joint for pain after contrast/needle placement confirmed via arthrogram.
Possible coding scenarios.
-20610 (steroid injection)
-27370 (injection for arthrogram contrast)
-77002 (fluoroscopy)
-73580 (radiological interpretation of arthrogram)
-Q9967 (contrast)
-Jxxxx (steroid)
Now some of us are saying that the provider should bill 20610, 77002, JXXXX and cannot bill the 27370/73580/77002 at all because a diagnostic arthrogram simply was not performed. A diagnostic arthrogram would be to diagnose, and not to evaluate contrast or confirm needle placement prior to a joint steroid injection.
Others believe the provider can bill the 27370/73580/77002/JXXXX/Q9967 only... and not the 20610 (in other words, one or the other).
One says that while the provider cannot bill the 27370/73580 they can still charge for the contrast if they did in fact, do an arthrogram (even if it was done for contrast flow eval/needle confirmation).
Yet others say they can bill it all!
WHAT SAY YOU?????
Patient having steroid injection in major joint (we'll go with the knee for purposes of all being on the same page).
- Provider performs an arthrogram to evaluate contrast/needle placement
- Injects contrast for the arthrogram
- Fluoroscopy for the athrogram
- Injects steroid into the knee joint for pain after contrast/needle placement confirmed via arthrogram.
Possible coding scenarios.
-20610 (steroid injection)
-27370 (injection for arthrogram contrast)
-77002 (fluoroscopy)
-73580 (radiological interpretation of arthrogram)
-Q9967 (contrast)
-Jxxxx (steroid)
Now some of us are saying that the provider should bill 20610, 77002, JXXXX and cannot bill the 27370/73580/77002 at all because a diagnostic arthrogram simply was not performed. A diagnostic arthrogram would be to diagnose, and not to evaluate contrast or confirm needle placement prior to a joint steroid injection.
Others believe the provider can bill the 27370/73580/77002/JXXXX/Q9967 only... and not the 20610 (in other words, one or the other).
One says that while the provider cannot bill the 27370/73580 they can still charge for the contrast if they did in fact, do an arthrogram (even if it was done for contrast flow eval/needle confirmation).
Yet others say they can bill it all!
WHAT SAY YOU?????