Anesthesia Coding Alert

Question: Our pain management physician sometimes performs a hip arthrogram and hip injection during the same patient encounter. Can we bill both services? Vermont Subscriber Answer: The codes in question include 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]), 27093 (Injection procedure for hip arthrography; without anesthesia), and 73525 (Radiologic examination, hip, arthrography, radiological supervision and interpretation). Current CCI edits list 20610 as a Column 2 code of 27093, which means you shouldn't normally report both procedures together if the physician performs the arthrogram and injection on the same hip. The bundle does allow you to report a modifier, however, to differentiate between services in some instances. Check your documentation to determine whether a modifier such as 59 (Distinct procedural service) might be justified. If you can't report both 20610 and 27093 for the encounter, submit only 27093 with 73525.