Do you mean the patient had both the left and right ankle done? Your question sounds like one ankle, both the left and right side of that one ankle?
20600 is for a small joint; 20605 is for an intermediate joint - so the correct code is 20605 for the ankle.
If only one ankle, it would only be one code, 20605. If both the right and left ankles, you would bill 20605-50 to Medicare (at least our MAC wants it on one line with a 50 modifier). An alternate to one line with the 50 modifier is 20605-LT on one line, and 20605-RT on the other.
Hope this helps,
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