Orthopedic Coding Alert
Consider AC Joint as Intermediate
PDF
Question: If our surgeon injects a patient’s AC joint, should we report 20610? We consider it a large joint because it’s in the shoulder, but we aren’t sure if that’s accurate.
Florida Subscriber
Answer: When the surgeon performs an injection to the AC (acromioclavicular) joint, you should report 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa] without ultrasound guidance).
Many coders mistakenly believe that they should report 20610 (... major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for this type of injection because the AC joint is between the shoulder and the clavicle, and 20610’s descriptor references the shoulder.
But 20605’s descriptor specifically describes the acromioclavicular joint, so you should always report 20605 for AC joint injections.
Related Articles
Orthopedic Coding Alert
- Case Study:
Examine This Lesion Excision Coding Scenario and See What is Missing
Go in-depth with both your CPT® and ICD-10 coding options. The reports you receive aren’t [...] - Lesions:
Avoid Excision Coding Snafus With These 3 Steps
Example 2 reveals why you need to watch for the narrowest margin. When patients with [...] - News You Can Use:
Discover More About The Medicare Drug Spending Dashboard
Learn more about prescribing trends, drug utilization; do not expect to see price concessions. The [...] - ICD-10:
Access Your 3 Achilles Tendon Rupture Options
Don’t miss this Excludes2 note. A complete rupture of the Achilles’ tendon often occurs spontaneously [...] - Reader Question:
Learn How Leg Amputations Differ
Question: How do leg amputation codes differ from each other? Minnesota Subscriber Answer: Technique differentiates leg amputation [...] - Reader Question:
Strike Through Fracture Care Code Without Fx
Question: If our physician sees a patient in the office and dictates that the patient does [...] - Reader Question:
Pick Apart 'Primary' vs. 'Secondary'
Question: For codes such as 27695, 27696 and 27698, what do the terms “primary” and “secondary” [...] - Reader Question:
Failed Reduction May Mean Modifier 52
Question: The orthopedic surgeon saw a patient in the emergency department for a medial elbow dislocation. [...] - Reader Question:
Consider AC Joint as Intermediate
Question: If our surgeon injects a patient’s AC joint, should we report 20610? We consider it [...] - Reader Question:
Follow the '72285 Includes 77003' Rule
Question: May I report CPT® 77003 and 72285 together for the same service? A coworker told [...] - Reader Question:
How to Report the Proper Pectoralis Code
Question: Which CPT® code should I report for a torn pectoralis major muscle repair? South Dakota [...] - You Be the Coder:
Modifier 53 with E/M for Cancelled Surgery
Question: Our surgeon decided not to take the patient for an elective surgical procedure. The patient [...]
