Wiki 20551 vs 20610

aparscal

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M Doctor is billing a 20551 and I do not agree with the procedure she chose. I think she should have billed a 20610 because she injected into the left trochanteric bursa.

Her note indicates Patient with rheumatoid arthiritis and currently on Plaquenil therapy. According to the patient she is up to date with her eye examination. She is on relatively low-dose 200 mg once a day. With no active peripheral joint synovitis we'll not consider putting her back on methotrexate typpe of medication. For the tronchanteric bursitis she was prepped in a usual sterile manner. Verbal consent was obtained.40 mg of Kenalog with 2cc 1% lidocaine was infiltrated into her left trochanteric bursa. She tolerated the procedure well. No complication.

My question is this..... because she is injecting into a major joint trochabnteric bursa shouldn't she be billing a 20610, rather than 20551. The patient has trochanteric burisitis is that why the doctor may be choosing 20551?, please help
 
I think your right. I need to brush up on my medical terminology but I don't believe he injected a tendon or ligament which is what a 20551 is. You can inject kenalog into a tendon so maybe she doesn't realize there are multiple codes based on where it was injected.
 
Perhaps you should show your provider the code descriptions from your CPT book:

20551 Injection(s); single tendon origin/insertion

20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance
 
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Better late than never

Because this was a joint injection (bursa) the correct CPT 20610.

20551 is for an injection directly into the tendons ligament at the origin and/or insertion point.
 
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