Primary Care Coding Alert

Question: A family physician performs a joint injection on the shoulder, which I plan on billing with 20610. Should I separately report the injection administration with 90782?


Idaho Subscriber
Answer: You should report the joint injection with only 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa ...). Because 20610's description states "Arthrocentesis, aspiration and/or injection," the code includes the injection.

In contrast, 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) describes a therapeutic, prophylactic or diagnostic injection. You would use 90782 for a preventive shot, such as Synagis for respiratory syncytial virus, or a restorative treatment, like Decadron for croup.

Don't forget to bill Medicare carriers with the corresponding G code instead of 90782. In 2005, CMS replaced 90782 with G0351 (Therapeutic or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular). 

Remember: You should separately bill for the substance the FP injects into the joint.