Joint injections are common procedures to relieve pain and inflammation in various joints. Utilizing medications such as corticosteroids or hyaluronic acid, joint injections can be used to help treat conditions like arthritis, tendinitis, bursitis and even certain injuries.
When coding for joint injections, you must consider a) the size of the joint being injected and b) whether ultrasound guidance was used during the procedure.
The coding options for joint injections are as follows:
20600 - Small joint or bursa without ultrasound guidance.
• This code is used for small joints such as fingers and toes.
• Note: Code 20604 is used for ultrasound guidance with permanent records and reporting.
20605 - Intermediate joint or bursa without ultrasound guidance.
• This code is used for Temporomandibular, Acromioclavicular, wrist, elbow or ankle and Olecranon bursa.
• Note: Code 20606 is used for ultrasound guidance with permanent record and reporting.
20610 - Major joint or bursa without ultrasound guidance.
• This code is used for major joints such as hips, knees and shoulders.
• Note: Code 20611 is used for ultrasound guidance with permanent record and reporting.
Remember to utilize modifiers and diagnosis codes based on laterality. For example:
- Right hip injection without ultrasound guidance for the treatment of Bursitis.
- 20610 RT
- Jxxxx
- Dx: M70.71
- Bilateral knee injection with ultrasound guidance for treatment of Arthritis.
- 20611 50
- Jxxxx
- Dx: M17.0
- Left elbow injection without ultrasound for treatment of pain.
- 20605 LT
- Jxxxx
- Dx: M25.522
Keep in mind an E/M may also be billed with a 25 modifier if the patient presents with a new condition OR if the patient presents for their scheduled injection for one condition, but the physician also evaluates the patient for a separate condition.
Proper coding of joint injections not only ensures accurate billing but also supports optimal reimbursement and reduces the risk of claim denials. By carefully selecting the correct codes based on joint size, use of ultrasound guidance, and laterality, healthcare providers can streamline the billing process and avoid costly errors, ultimately improving the financial health of the organization.
If you have any questions or would like support with your healthcare billing and coding practices, please contact us to learn more.
Lisa Preidis is a Coder II at Medic Management Group. MMG is a national provider of advisory and consulting competencies, transaction support services, and back office administrative support to independent and system owned physician practice groups.