-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki DX code for intra articular shoulder joint injection
- Thread starter mcdream
- Start date
xXxPARAGONxXx
Guru
It depends on what the procedure report actually describes.
The shoulder is a joint, “a region where 2 bones make contact” (Juneja, et al., 2024), known as the glenohumeral joint. It is where the head of the humerus (former image) articulates with the glenoid fossa of the scapula (latter image), — not to be confused with the shoulder girdle.
If indeed the procedure report describes an injection into the glenohumeral joint, it would be coded by 20610 (without imaging guidance). Glenomumeral joint intra-articular injection has several possible needle approaches: anterior (Schneider) approach, rotator interval approach, and posterior approach (Rastogi, et al., 2016). A well-documented procedure report should describe the approach, thereby providing insight about what exactly was injected.
If the acromioclavicular (AC) joint was injected — the AC joint being part of the shoulder girdle (Merrigan & Varacallo, 2023) — then it would be coded by 20605 (without imaging guidance). One approach is preferred for acromioclavicular joint injections: “...studies showed that the widest area for joint penetration was anterior superior" (Edelson, et al., 2014).
References
Clavicle. (n.d.). Kenhub. Retrieved June 13, 2024, from https://www.kenhub.com/en/study/the-clavicle
Edelson, G., Saffuri, H., Obid, E., Lipovsky, E., & Ben-David, D. (2014). Successful injection of the acromioclavicular joint with use of ultrasound: anatomy, technique, and follow-up. Journal of shoulder and elbow surgery, 23(10), e243–e250. https://doi.org/10.1016/j.jse.2014.01.012
Juneja, P., Munjal, A., & Hubbard, J. B. (2024). Anatomy, Joints. In StatPearls. StatPearls Publishing.
Merrigan, B., & Varacallo, M. (2020). Acromioclavicular Joint Injection. PubMed. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK547727/
Rastogi, A. K., Davis, K. W., Ross, A., & Rosas, H. G. (2016). Fundamentals of Joint Injection. American Journal of Roentgenology, 207(3), 484–494. https://doi.org/10.2214/ajr.16.16243
Shoulder (glenohumeral) joint. (n.d.). Kenhub. Retrieved June 13, 2024, from https://www.kenhub.com/en/study/anatomy-glenohumeral-joint
Last edited:
amyjph
True Blue
You can also refer to the parenthetical descriptions/examples in the CPT book for these codes. For example, 20610 - Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder hip, knee, subacromial bursa); without ultrasound guidance
Compare this description to 20605 or 20600 for example.
Compare this description to 20605 or 20600 for example.