Cubital Tunnel Injection

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My physician has done an injection of Depo -Medrol and Lidocaine into the patient's cubital tunnel near the elbow. He says it is similar to the carpal tunnel injection 20526. I am not sure how to code this. I have considered 20550, and also 64450. Neither option seems to fit the service exactly. Can I get some advice? I would really appreciate some input.
 

fish4codes

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I looked in KnowledgeSource (my coding software) and it gives G56.2- as a secondary concurrent diagnosis for 20526. 64405 and 20550 do not list G56.2- as a concurrent primary or secondary diagnosis. If I was going with just this I would go with 20526.
 

thomas7331

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I would not use 20526 if it is not a carpal tunnel injection. There's no specific code for a cubital tunnel injection, that I'm aware of, but it's not really possible to come up with an accurate code without being able to see an operative report or complete description of the procedure. If the codes two codes you considered above do not fit, you may need to use an unlisted code, e.g. 20999, suggesting 20526 to your payers as a comparably valued procedure.
 
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Patricia Burgman, CPC

I appreciate the help. This is a work comp patient and the note will accompany the charges. I think I will bill with an unlisted code and explanation.
 
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Was this procedure performed for the patient being diagnosed with Cubital Tunnel Syndrome? The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow. Cubital Tunnel Syndrome is a peripheral neuropathy due to the chronic compression or repetitive trauma to the ulnar nerve. If your provider performed the injection into this area than CPT 64450 is the correct code.
 

apagano1

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injection for cubital tunnel (ulnar neuropathy)

I looked in KnowledgeSource (my coding software) and it gives G56.2- as a secondary concurrent diagnosis for 20526. 64405 and 20550 do not list G56.2- as a concurrent primary or secondary diagnosis. If I was going with just this I would go with 20526.
I used 96372, if other injections are listed use 59 modifier with this.
 

mitchellde

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I used 96372, if other injections are listed use 59 modifier with this.
What exactly did you use 96372 for? If you used this code for anything other than an IM or SQ injection then it is incorrect and you are severely undercoding. You must look closely at what is being injected. This was a cubital tunnel injection with is neither IM nor SQ. so 96372 would not be a correct choice.
 
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