Reader Question: Hip Injection

Question: A patient with osteoarthritis of the hip presents for aspiration of the hip under fluoroscopy. The operative report states that a confirmatory arthrogram was obtained to ensure the position of the hip. Would it be correct to code 27093 (injection procedure for hip arthrography; without anesthesia) (packaged; no APC reimbursement) and 73525 (radiologic examination, hip, arthrography, radiological supervision and interpretation) (APC 275)? The national Correct Coding Initiative (CCI) edit for the fluoroscopy (76003) says it is a component of the procedure. Will we only receive reimbursement for one APC?

Jan Weins RHIA
East Texas Medical Center
Athens, Texas

Answer: The correct procedure code would be 20610 (arthrocentesis, major bursa [e.g., shoulder, hip, knee joint, subacromial bursa]). This code should not be affected by the CCI edits when you code it along with the radiology procedure. Also, you need to use a modifier on the procedure code to indicate the left or right hip (-LT or -RT).


Sources for Reader Questions and You Be the Expert are Jim Murdy, controller, Wheeling Hospital Inc., Wheeling, W.Va.; Rosemary Hakenwerth, MBA, RHIT, CCS, Consultant with Healthcare Coding & Reimbursement Solutions, St. Louis, Mo.; Susan Cook, department of psychiatry billing manager, University of Michigan, Ann Arbor, Mich.; Ruthie Burden, CCS, CPC, CPAR, medical records coding office, St. Joseph Hospital, Augusta, Ga.; Joanne Smith, MT (ASCP), corporate compliance officer/safety officer, Valley Hospital, Palmer, Ark.; Caral Edelberg, CPC, CCS-P, president of Medical Management Resources Inc., an ED coding consulting firm in Jacksonville, Fla.; and John Turner, MD, PhD, medical director for documentation and coding, healthcare financial services at TeamHealth, an ED staffing firm in Knoxville, Tenn.

- Published on 2001-02-01