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Orthopedic Coding Alert

Reader Questions:

Avoid Trigger Point Codes for Trochanteric Bursa

Question: How should I code injection of trochanteric bursa and sacral crest? My orthopedic surgeon wants to use a trigger point code, but I disagree.

Iowa Subscriber
Answer: The CPT code for the trochanteric bursa injection is 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]). 

It's likely that either 20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar -fascia-]) or 20551 (... single tendon origin/insertion) applies to the sacral crest injection, but you may want to check with the surgeon before you actually file the claim.

Because the sacrum has many ligament and tendon attachments, it's possible that he could be injecting those structures rather than a muscle at the sacral crest. You Be the Coder and Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.; and Bill Mallon, MD, a practicing orthopedic surgeon and the medical director at Triangle Orthopaedic Associates in Durham, N.C.

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