Wiki Joint injection/procedure

[sevans91]

Our patient was in Dr's schedule for a check-up, requesting joint injection for his shoulder pain. After exam 3 injections were given.

Cpt-20610 Arthrocent-large and J1040 depo-medrol-80mg for dx:
1-degenerative arthritis of R shoulder -715.91
2-tendonitis of shoulder R shoulder 726.10
3-bicipital tenosynovitis 726.12
4-Acromioclavicular joint arthritis

Next he c/o pain and swelling of thumb after removing a splinter few days ago. As it turns there was still a piece of splinter that was infected. Doctor removed it.
Cpt 10120, removal dx: foriegn body of right thumb with infection 915.7

Do I list each injection with a dx or 20610 mod 51 and J1040 x3?
Then add 99213 mod 25, 10120 for splinter removal?

Thanks

 

[ewinnacott]

Since the injections were all done in the shoulder it would be 20611. I'm not 100% sure if you would use the x3 or -51 mod since it was done in one place (shoulder). I don't think you would in my opinion. So the coding I would do would be as follows:

20611 x1 w/dx 715.91,726.10,726.12
99213-25 w/dx 915.7
J1040 x1 (unless 3 vials were used then x3)

With the 10120 did the Dr make an opening to remove the splinter and was the part of the splinter he missed sticking out or subcutaneous? Honestly since the Dr removed it a few days ago I think the office visit would just apply since I'm guessing the 10120 was coded initially to remove it at the prior office visit. You can try the 10120 and see what happens it can't hurt.

Hope this helps

 

[sarahjanejones]

I respectfully disagree with the above guidance. 20611 states "with ultrasound guidance". I don't see where you refer to guidance being used. I would do 20610-RT x 1 unit (assuming all of the injections went into the joint itself???) with all of the shoulder related diagnoses listed. At best, if the injections were given in the shoulder joint and bursa, then you could likely bill 2 units. Just my opinion....