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20610 (Superior and Inferior SI joint injections)

C

CoderinJax

Guru
Messages
108
Location
Jacksonville, FL
Hello all,
I need some assistance to see if my thought process is correct in regards to the injection CPT code and units.

I have a Physician billing injections for the Superior and Inferior SI joints (BILATERAL), with CPT code 20610 x4.

The record states 4 units for this, and I'm guessing this reasoning is below:
RT Superior=1
RT Inferior= 1
LT Superior= 1
LT Inferior= 1

My thought is, since the SI is only ONE joint there should only be one unit billed per side, regardless of Superior/Inferior. So in this case TWO total would be correct, not the 4 on the record.
Am I correct in this, or should I expect to see the 4?

Thanks so much for whatever supporting documentation you guys have either way.
 
You are correct, it is per joint.

Per Encoder: These codes should be reported only once even if an aspiration and injection are performed during the same session. Local anesthesia is included in these services. Do not report 20600-20604 in conjunction with 76942. Do not report 20600 or 20604 with 0489T-0490T. If fluoroscopic, CT, or MRI guidance is used, report 77002, 77012, or 77021. For aspiration or injection of a ganglion cyst, see 20612. Supplies used when providing these procedures may be reported with the appropriate HCPCS Level II "J" codes. Check with the specific payer to determine coverage.


Also: http://https://www.aapc.com/blog/27495-problem-code-20610/

And: http://http://blog.supercoder.com/my-skill-sharpener/dont-get-stuck-when-reporting-20610-for-joint-injections/
 
Helpful, thanks!

Thanks so much! I had read these posts and they were what helped me know I was on the right path, but seeing you reference them helped me think it's accurate, so I appreciate that. :)
However, I just came across the linked article and I'm now thinking trigger points are the code range I should be looking at. There was no guidance and it appears the SI Joint(s) are not considered major joints. Phys can't bill 27096 since no CT/Fluoro was used.

https://www.aapc.com/blog/26649-straight-up-coding-for-sacroiliac-joint-injections/

What do you think?
 
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