ED Coding and Reimbursement Alert

Question: We report code 20600 (Arthrocentesis, aspiration and/or injection, small joint or bursa [e.g., fingers, toes]; without ultrasound guidance) from time to time but we are unclear of what the difference is between arthrocentesis and aspiration. Can you advise?

Codify Subscriber

Answer: When the ED physician performs arthrocentesis, he or she uses a needle or syringe to remove fluid from a joint, typically to ease pain. Aspiration, on the other hand, refers to the removal of fluid or cells from a body cavity via suction, such as with a trocar or needle and syringe.

You can check for these techniques on the operative note to determine which service your physician performed, but since CPT^® instructs coders to use 20600 for arthrocentesis/aspiration/injection of a small joint or bursa, you’ll report this code no matter which service is performed on the small joint or bursa.