Wiki Multiple Units for CPT 20605

[lcole7465]

My doctor performed a costochondral joint injection @ T4,5 & 6. He wants to bill 20605 x 3. I know that this code is usually billed as 1 UOS, however since this actually 3 separate joints, would the 3 UOS be correct? I'm just looking for some clarification.

Thanks

 

[dwaldman]

If you are billing Medicare it appears the MUE--Medically Unlikely Edit is only 2 for CPT 20605

20605 2


https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE.html

Here the MUE table above



I not for sure regarding the units for this procedure, I would agree with the physician that if they are separate joint injections that multiple units would wanted be used but when reviewing AMA CPT Knowledge Base Q & A from 2015 they refer to 20605 in the plural form but that might not necessarily mean that meant only one unit. I could see using multiple units but the MUE issue is something to consider

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AMA CPT Knowledge Base 06/12/15

What would be the appropriate code to report costochondral joint injections?

From a CPT coding perspective, it would be appropriate to report CPT code 20605 (REVISED IN 2015), Athrocentesis, aspiration, and/or injection; intermediate joint, bursa or ganglion cyst (i.e. temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa), for costochondral joint injections.