Wiki 20610 W/Knee or Shoulder Arthroscopy

[joanne71178]

I would like to get some opinions on the ethics of coding 20610-59 w/Knee and/or Shoulder Arthroscopies.

One of the offices I code for want me 20610 with Knee scopes such as Menisectomies, Abrasion Arthroplasties, etc. As well as Shoulder scopes- RTC, debridements, etc.

The doctors simply states at the end of the note "The Knee/Shoulder joint was injected with a solution of 20 ML of .25% Marcaine with epinephrine and mg of morphine before a sterile compressive dressing was applied."

When I pull it up on codeitright.com there is a 'warning' but not an 'error'. I have heard yes code it, but I"ve also been told it might be unethcal. The insurance companies are paying, but that does not tell me if I should really be coding it or not.

Thanks in advance.

 

[WulbernC]

Knee Arthroscopies w/20610

I would like to get some opinions on the ethics of coding 20610-59 w/Knee and/or Shoulder Arthroscopies.

One of the offices I code for want me 20610 with Knee scopes such as Menisectomies, Abrasion Arthroplasties, etc. As well as Shoulder scopes- RTC, debridements, etc.

The doctors simply states at the end of the note "The Knee/Shoulder joint was injected with a solution of 20 ML of .25% Marcaine with epinephrine and mg of morphine before a sterile compressive dressing was applied."

When I pull it up on codeitright.com there is a 'warning' but not an 'error'. I have heard yes code it, but I"ve also been told it might be unethcal. The insurance companies are paying, but that does not tell me if I should really be coding it or not.

Thanks in advance.

Per the CPT Assistant Article dated Dec 2007 Vol 17 Issue 12 Pg 10, "CPT 20610 should not be reported when performed concurrently with an other intraarticular procedure (eg knee arthroscopy)." With this in mind, you would not want to report 20610 with 29881 et al. Per CCI edits, 20610 bundles into 29881 so it would not be reported separately. In using either AMA or CCI edits 20610 may be bypassed with a -59 but only if done on a separate and distinct anatomical site than the surgical procedure. I hope this helps!

 

[joanne71178]

Yes, that is extremely helpful.

Thank you!