Wiki 64450 vs 20610, etc.

ECHRISTIE

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Looking for confirmation -
Need to support my recommendation that an anesthesiologist should not be performing an intraarticular knee joint injection ( lidocaine) prior to meniscus surgery and documenting it as 64450 for post operative pain. #1 IMO - the correct code is 20610 and #2. this injection is part of the surgical package , ( *local infiltration , metacarpal/metatarsal/digital block or topical anesthesia).
Thanks
 
Hi there, I agree that you wouldn't report an injection as a block. The note should make it easy to determine what the provider did.

In addition, if the anesthesiologist was performing a genicular nerve block for post-op pain they would report 64454 or 64454-52 if they didn't treat all three nerves, and there would need to be a documented request from the surgeon.
 
Looking for confirmation -
Need to support my recommendation that an anesthesiologist should not be performing an intraarticular knee joint injection ( lidocaine) prior to meniscus surgery and documenting it as 64450 for post operative pain. #1 IMO - the correct code is 20610 and #2. this injection is part of the surgical package , ( *local infiltration , metacarpal/metatarsal/digital block or topical anesthesia).
Thanks
I agree with you on #1, 64450 isn't the correct code for an intra-articular joint injection. However, I don't agree with #2 - this kind of injection doesn't fall into any of those categories (topical, local infiltration or digital block) and in addition, the surgical package would apply only to the surgeon performing the meniscus surgery. Anesthesia by the surgeon is a component of the surgical package, but services of other physicians of different specialties are not component of the package. It would be appropriate for the anesthesiologist to report the injection with the correct code, provided it isn't bundled to any other procedures performed by that same physician.
 
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