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Coding shoulder manipulation w/injection - Noone replied to my question

  1. Default Coding shoulder manipulation w/injection - Noone replied to my question
    Medical Coding Books
    Coding shoulder manipulation w/injection


    Noone replied to my question, so I am resending. I am showing on CCI edits that 20610 is bundled with 23700 as of Jan. 1, 2011. Can these two codes be billed together for this procedure? This is for same shoulder. See op note below. I am ASC. Physicians office says we can.
    I appreciate any info.


    PREOPERATIVE DIAGNOSIS: Right shoulder capsulitis frozen shoulder.

    POSTOPERATIVE DIAGNOSIS: Right shoulder capsulitis frozen shoulder.

    PROCEDURE: Right shoulder manipulation under general anesthesia with brachial plexus block by the anesthesia service and intraarticular infiltration of Marcaine, morphine, and Kenalog solution.

    OPERATIVE PROCEDURE: The patient was brought to the operating room and general anesthesia was administered. A brachial plexus was performed by the anesthesia service. I then proceeded with manipulation. The patient had an extremely stiff shoulder. Abduction was limited to about 60 degrees, external rotation to only 10 degrees, and internal rotation to 10 degrees. Progressively, I proceeded with rotation with loud crepitus upon bringing the shoulder to nearly full abduction. Then I progressively brought back external rotation to about 75-80 degrees. I then proceeded with adduction and internal rotation that was symmetric to the opposite side.

    After sterile preparation and C-arm control, infiltration was carried out with Marcaine, morphine, and Kenalog solution into the joint space. The patient was returned to the recovery room in stable condition.


  2. Default
    I would go with what the CCI edit says. If you bill them separately one will just be denied as bundled if you are correct then you will not have this debate with the physician's office again. Maybe the physician's office is not up to date with their billing practices being that this IS January. Things change all the time. I hope this helps.

  3. Default
    I really appreciate the reply and your opinion. I hate to second guess myself.

    Thanks again,
    Vickie Mounce

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