Ultrasound guided injections

RMonte17

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Can anyone please clarify for me billing ultrasound guided injections for a sports medicine physician with an AIUM certification?

It is my understanding we cannot bill 76942 with 20610 any longer, instead we should be using 20611. He does a lot of knee injections with Euflexxa (J7323) and Orthovisc (J7324). Also, we have the ultrasound machine in the office. In the past we would bill the following:

99213 -25
76942 -59
20610
J7323 or J7324

If we are now only to bill 20611 for this scenario when would it be appropriate to bill a 76942? Any and all advice is greatly appreciated as we are in a great debate in our office over this issue
 

Chelle-Lynn

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The initial parenthetical note following these codes restricts reporting of code 76942 in conjunction with code 20611, as the value of the ultrasound is already calculated into the fee schedule for the 20611.

Both aspiration and/or injection are inherently included as part of the service as noted in the descriptors for this code. Code 20611 is not intended to report the injection of contrast materials into the knee.
 
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