Cpt codes, please?

[solocoder]

Could I get some opinions, please, on how to code these injections?

Injected Kenalog 20 mg mixed 50:50 with Lidocaine 2%, 0.67ml total to the sinus tarsi, R.
Injected Kenalog 10 mg mixed 50:50 with Lidocaine 2%, 0.67ml total to the lateral ankle gutter by plantar approach, R.
Injected Kenalog 10 mg mixed 50:50 with Lidocaine 2%, 0.67ml total to the medial ankle gutter by plantar approach, R.

 

[syllingk]

I think it depends on the carrier how they want multiple units billed but I think it would be 20605 x 3, You didnt say the strenght of the kenalog but I will assume it is kenalog 40 so it would be J3301 (40 Me) x 4 units NDC 00003-0293-05

 

[cmartin_333]

I don't have my cpt book with me but look at these codes:

J1030 - Kenalog

CPT Codes:
20550 - Tendon
20600 - Small joint
20605 - Intermediate joint
20610 - Large joint

***ankles are typically considered an intermediate joint. If the physician injected these sites at seperate intervals then my first thought would be to add the modifier -59 for the last two injections. I am not certain if the sinus tarsi falls under the tendon 20550.

ex. 20605, 20605-59, 20550-51 and map the appropriate dx.

as far as the Kenalog injection I am not sure if you would use units based off the dosage for each injection given. ex. j1020 - 20mg j1030 - 40mg j1040 - 80mg

I am not saying this is accurate information but I am just trying to possibly point you in a direction. I hope this helps you.

christy, CPC

 

[solocoder]

Since all the injections are in the same ankle, would they not be bundled? Can someone give me a little more specific definition of "different anatomical site"? Do you think this doctor is splittting hairs here?
THANKS.