Podiatry Coding & Billing Alert

Reader Question:

Check Medical Necessity, Calendar for ED Observation Services that Transcend Midnight

Question: How do you find the correct CPT® code for sinus tarsi injection?

Answer: Coding for a sinus tarsi injection is little challenging since the sinus tarsi is neither a joint nor a ligament — it is a space. The area is the soft indentation just in front of the lateral malleolus and contains nerve endings, fat, joint capsule, arterial anastomoses, and five ligaments.

You must identify the location where your physician has administered the injection. If your physician had administered an injection into the surrounding soft tissue you will code 20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar “fascia”]). If it is in the actual sinus tarsi space, which provides the lateral access to the subtalar joint, then you can report with 20605 (Arthrocentesis, aspiration and/or injection, intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]; without ultrasound guidance).

Tip: Don’t forget to include a corresponding J code to get reimbursement for the drug administered.