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Tricks to code Cpt code for Arthrocentesis

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Tricks to code Cpt code for Arthrocentesis Arthrocentesis is a procedure of removal of synovial fluid for the joint space. It is also called as joint aspiration. Cpt code for arthrocentesis is very important. Arthrocentsis is also done to inject fluid in joint space for drug therapy. The procedure to code arthrocentesis in interventional radiology coding is depends on the type of joints the injection and/or aspiration done. Arthrocentesis is used in the diagnosis of gout, arthritis and synovial infections.

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Cpt code for arthrocentesis

The CPT code for arthrocentesis is divided into three different types of joints. The joints are divided as small, intermediate and major joints. The small joints include the fingers, toes, joint or bursa. The intermediate joints includes the wrist, elbow, ankle, olecranon bursa or temporomandibular. The major joints include the shoulder, hip, knee joint or subacromial bursa.

Procedure performed during arthrocentesis

 The procedure takes place in sterile condition. The physician inserts a needle attached with the syringe in the joint space. The synovial fluid is aspirated from the joint space. For injection procedure, the physician injects the drug for drug therapy. The procedure is done under the imaging guidance. The needle is guided under imaging guidance until it reaches the targeted area. Hence, guidance is required with cpt code for arthrocentesis.

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Imaging guidance used with CPT code for arthrocentesis

There are four different imaging guidance used in the arthrocentesis. The four imaging guidance are Fluoroscopic, ultrasound, MRI and CT guidance. When we code a CPT code for arthrocentesis, we have to bill the imaging guidance. Hence, when we code the arthrocentesis we will code two CPT codes, one for main procedure code for arthrocentesis followed by the imaging guidance used during the procedure. Below are the detail description of arthrocentesis CPT codes.

CPT codes without Ultrasound (76942) guidance

20600: Arthrocentesis, aspiration and /or injection, small joint or bursa (eg, fingers; toes); without ultrasound guidance, with permanent recording and reporting.

20605: Arthrocentesis, aspiration and /or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, writs, elbow or ankle, olecranon bursa;);without ultrasound guidance, with permanent recording and reporting.

20610: Arthrocentesis, aspiration and /or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance, with permanent recording and reporting.

CPT codes with ultrasound guidance

20604: Arthrocentesis, aspiration and /or injection, small joint or bursa (eg, fingers; toes); with ultrasound guidance, with permanent recording and reporting.

20606: Arthrocentesis, aspiration and /or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, writs, elbow or ankle, olecranon bursa;);with ultrasound guidance, with permanent recording and reporting.

20611: Arthrocentesis, aspiration and /or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting

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 When we code bilateral joint aspiration on both sides, we can use the 50 along with cpt 20600, 20604, 20605, 20606, 20610 and 20611. But, when the joint aspiration is done on two different small joint or major joints, we have to use 59 modifier with any of the cpt. For example, if arthrocentesis is done on shoulder and hip joint, then we can code 20610 and 20610-59 modifier. Hence, by giving 59 modifier we distinct the first procedure cpt for another one.
Below is the detail description about the arthrocentesis cpt codes along with imaging guidance.

Procedure Description

Procedure Code

Fluoroscopic

guidance

Ultrasound guidance

MRI guidance

CT guidance

Arthrocentesis or joint aspiration from small joints like toes, fingers etc

20600/20604

77002

76942 not to be coded with 20600/20604

77021

77012

Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular,

acromioclavicular, wrist, elbow or ankle, olecranon bursa])

20605/20606

77002

76942 not to be coded with

20605/20606 

77021

77012

Arthrocentesis aspiration and/or injection:major joint or bursa [e.g., shoulder, hip, knee joint,

subacromial bursa]

20610/20611

77002

76942 not to be coded with 20610/20611 

77021

77012

Hope, now you can code cpt code for arthrocentesis based on the type of joint studies. Please share if you like the article.

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