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Orthopedic Coding Alert

Reader Question:

Consider AC Joint as Intermediate

Question: If our surgeon injects a patient’s AC joint, should we report 20610? We consider it a large joint because it’s in the shoulder, but we aren’t sure if that’s accurate. 

Florida Subscriber

Answer: When the surgeon performs an injection to the AC (acromioclavicular) joint, you should report 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa] without ultrasound guidance).

Many coders mistakenly believe that they should report 20610 (... major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for this type of injection because the AC joint is between the shoulder and the clavicle, and 20610’s descriptor references the shoulder.

But 20605’s descriptor specifically describes the acromioclavicular joint, so you should always report 20605 for AC joint injections.

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