Eli's Rehab Report

Reader Questions:

Code Barbotage as Joint Injection

Question: Our physiatrist documented "barbotage of a calcific density in the supraspinatus tendon" under fluoroscopic guidance. How should we report this procedure?

Tennessee Subscriber

Answer: If the physician documents barbotage, he most likely aspirated a site and then immediately injected the same site. You should report 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for this procedure, along with 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) for the fluoroscopy.
 
Although some coders erroneously report two units of 20610 for this service - one unit to reflect the aspiration and one unit for the injection - you should code 20610 only once. Because its descriptor refers to "aspiration and/or injection," one unit of 20610 covers both the aspiration and the injection.