I was always told that for arthrograms such as with the Hip and SI joint unless it was done for a diagnostic reason you really cannot bill the arthrogram even though there may be a separate report for it. Doc. wants to bill 27095 & 73525. I want to bill 20610 & 77002.

I provided the Op report below:

DX: left hip degenerative joint disease

64 year old male who has had unrelenting pain and dysfunction with his left hip. A left hip MR arthrogram did show degenerative joint disease. Because of this persistent pain and dysfunction he felt that an arthrography with follow up intraarticular steriod injection would be a benefit.

Tip of needle in between superior aspect of the acetabulum and the femoral head. We then injected Omnipaque confirming good intraarticular placement of the needle. The dye outlined the femoral head tracking into the acetabulum down to the fovea and around the head. We then removed this syringe in tubing and then injected 40mg of Depo Medrol and 2cc of o.25% marcaine into the joint. We then withfrew the needle, took a final C-arm image confirming the needle was out of the joint. The dye circulated within the hip joint confirming good intraarticular placement. We then cleansed the skin, applied Lidoderm patch.

The patient underwent left hip arthrogram and intraarticular injection to the left hip on Feb..... Fluoroscopy images show a spinal needle located between the superior aspect of the femoral head and acetabulum. Subsequent images show dye outlining the femoral head and acetabulum going down towards the fovea confirming good intraarticular placement of the needle.

Successful left hip arthrography with good intraarticular needle placement.