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Eli's Rehab Report

You Be the Coder:

Medial Epicondyle Injection

Published on Sat Dec 01, 2001 Print Friendly and PDF PDF

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.

Question: What is the appropriate CPT code for a medial epicondyle injection with a diagnosis of medial epicondylitis? Should I use 20605 or 64450?

Maryland Subscriber

Answer: Based on the information you provided, CPT 20605 (arthrocentesis, aspiration and/or injection; intermediate joint, bursa or ganglion cyst [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]) is the correct choice, linked with ICD-9 code 726.31 (medial epicondylitis). The description of the code, taken from the Group Health Care LMRP, leaves little doubt that this is correct for your case: "Arthrocentesis involves aspiration and/or injection into a joint space, under sterile conditions, to obtain a fluid specimen for analysis or for instillation of local drug therapy, usually corticosteroid." Report 20605 if an intermediate joint, bursa or ganglion cyst is injected.
 
The Group Health policy states, "CPT code 64450 applies only to anatomic nerve block and should not be used for other types of local anesthesia." Therefore, 20605 is the more appropriate code for the procedure you performed.

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