margaret fahy
Guru
03/10/14
Guys,
How would you code these, in terms of guidance, and the mods?
They're all 20605...one tmj...then two in each ankle...so i'd have 20605, 20605-rt,20605-lt,20605-rt,59,20605-lt-59?....or would i use the 59 on all after the first one?
GUIDANCE.....do you bill for just guidance X1...per session?....or do you do guidance for each one?
and they used US, Fluoro, and Dyna Ct?....76942 is the primary code over the other two...so would I code just 76942 X1?
Please give me some input.
Thanks.
Margie
CLINICAL HISTORY: Symptomatic juvenile idiopathic arthritis.
PROCEDURE:
Limited ultrasound of the right TMJ was performed to choose a
site for insertion of the needle. The skin overlying the site
was marked. The skin of the right pre-auricular area was prepped
and draped in sterile fashion. Using US guidance a 25-gauge
needle was inserted into the right TMJ and confirmed by dyna CT.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the right ankle was performed to identify the
sub-talar joint and choose a site for insertion of the needle.
The skin overlying the site was marked. The skin of the right
ankle was prepped and draped in sterile fashion. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
right sub-talar joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 1.0 ml
(20mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the right ankle was performed to identify the
talonavicular joint and choose a site for insertion of the
needle. The skin overlying the site was marked. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
right talonavicular joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the left ankle was performed to identify the
sub-talar joint and choose a site for insertion of the needle.
The skin overlying the site was marked. The skin of the left
ankle was prepped and draped in sterile fashion. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
left sub-talar joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 1.0 ml
(20mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the left ankle was performed to identify the
talonavicular joint and choose a site for insertion of the
needle. The skin overlying the site was marked. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
left talonavicular joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
There were no complications and the patient left the IR suite in
stable condition. Dr. was present for the entire
procedure.
Permanent ultrasound, CT, and fluoroscopic images were obtained
and stored in the PACS system.
IMPRESSION
Successful, uncomplicated right TMJ injection,
bilateral sub-talar joint injection, and bilateral talonavicular
joint injection.
Result History
IR ASPIRATION OR INJ. ANKLE
Guys,
How would you code these, in terms of guidance, and the mods?
They're all 20605...one tmj...then two in each ankle...so i'd have 20605, 20605-rt,20605-lt,20605-rt,59,20605-lt-59?....or would i use the 59 on all after the first one?
GUIDANCE.....do you bill for just guidance X1...per session?....or do you do guidance for each one?
and they used US, Fluoro, and Dyna Ct?....76942 is the primary code over the other two...so would I code just 76942 X1?
Please give me some input.
Thanks.
Margie
CLINICAL HISTORY: Symptomatic juvenile idiopathic arthritis.
PROCEDURE:
Limited ultrasound of the right TMJ was performed to choose a
site for insertion of the needle. The skin overlying the site
was marked. The skin of the right pre-auricular area was prepped
and draped in sterile fashion. Using US guidance a 25-gauge
needle was inserted into the right TMJ and confirmed by dyna CT.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the right ankle was performed to identify the
sub-talar joint and choose a site for insertion of the needle.
The skin overlying the site was marked. The skin of the right
ankle was prepped and draped in sterile fashion. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
right sub-talar joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 1.0 ml
(20mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the right ankle was performed to identify the
talonavicular joint and choose a site for insertion of the
needle. The skin overlying the site was marked. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
right talonavicular joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the left ankle was performed to identify the
sub-talar joint and choose a site for insertion of the needle.
The skin overlying the site was marked. The skin of the left
ankle was prepped and draped in sterile fashion. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
left sub-talar joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 1.0 ml
(20mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
Fluoroscopy of the left ankle was performed to identify the
talonavicular joint and choose a site for insertion of the
needle. The skin overlying the site was marked. Using
fluoroscopic guidance a 25-gauge needle was inserted into the
left talonavicular joint space. Intra-articular position was
confirmed with injection of a small amount of Omnipaque 300.
Once position of the needle within the joint was confirmed 0.5 ml
(10mg) of Aristospan was injected into the joint. The needle was
then removed and hemostasis achieved with manual compression.
There were no complications and the patient left the IR suite in
stable condition. Dr. was present for the entire
procedure.
Permanent ultrasound, CT, and fluoroscopic images were obtained
and stored in the PACS system.
IMPRESSION
Successful, uncomplicated right TMJ injection,
bilateral sub-talar joint injection, and bilateral talonavicular
joint injection.
Result History
IR ASPIRATION OR INJ. ANKLE