Wiki Shoulder Injections

Lion21

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What is the correct way to bill for acromioclavicular (20605), subacromial space(20610) and glenohumeral joint (20610) injections into the same shoulder?
If the injection is given with one needle same shoulder ac 20605 and subacromial space 20610. Or ac 20605 with glenohumeral 20610. Can you bill for both since the ac and gh are separated by the joint capsule and the documentation states two separate locations?
If someone could share their knowledge or where I can find information on this. I would greatly appreciate it. Thanks in advance!
 
Before you can figure out what codes you can bill, you first have to identify the insurance that your billing first. CMS updated the orthopedic surgery NCCI policy manual this year. The update clearly states that CMS considers the shoulder to be a single anatomical unit (which of course, it's not, it's much more complicated than that). If your insurance is either Medicare or a Medicare replacement policy, you cannot bill any procedures that hit an edit on the same shoulder. If your insurance is not Medicare, check your edits and see what is allowed and if there is a diagnosis that supports each code. (two cents)
 
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