Wiki Hydroplasty - shoulder (2nd request)

[sfaltinson]

Is anyone familiar with billing for hydroplasty of the shoulder? We have our radiologist positioning the needle (20610) with fluoro imaging (77002) and contrast (Q9965). Then the ortho surgeon comes in and actually injects the saline (code?) as well as some Marcaine (J3490) and Kenalog (J3301). The patient then goes to physicial therapy where the joint is mobilized. My questions are (1) Who bills what?, (2) Does separate dictation need to be done by both the radiologist and the orthopedist?, (3) Is the saline billed since using such a large amount? Any insight is appreciated. Thanks!

 

[sfaltinson]

For those interested, here is how we have decided to bill for hydroplasty of the shoulder:

Physician:
23929 (unlisted) - hydroplasty ... saline is included in the price
J3301 - Kenalog (Marcaine bundled)

Radiologist:
20610 - shoulder injection
77002 - fluoro guidance
Q9965 - Omnipaque contrast

Each provider has to dictate their portion of their service. We do not yet have responses back from payers.

Sara