I thought your question was really interesting. I didn't realize that a modifier -59 could be used on J codes. I looked up cpt 20610 on the CCI Edits and it does list J2001 as a component code, however, the modifier indicator is (1) so a -59 is allowed to unbundle it.
My thinking is that since the injection site has to be anesthetized with the lidocaine in order to perform the arthrocentesis, it is considered "included". By adding the -59 modifier, you are telling Medicare that there is some reason why you are unbundling the lidocaine from the arthrocentesis being done. Does your MD use lidocaine for other than blocking the injection site?
Hope this helps & thanks for helping me to learn something new from your question!
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