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20610 and 27093 and 73525

Ruthie Posted Thu 27th of September, 2012 14:09:22 PM

In the situation described below, can you code the '20610'-59, '27093', '73525' or would you only code the '27093' and '73525'

PROCEDURES:
1. Hip injection.
2. Right hip arthrogram.
3. Right hip fluoroscopic guidance.
4. Injection of corticosteroids.
5. Right hip aspiration.

INDICATIONS:
1. Hip osteoarthritis with recurrence of pain, perhaps effusion.

INFORMED CONSENT: She understood the rationale of doing the arthrogram
before injection, then the injection itself. Aspiration may be necessary.

INTERPRETATION: Assumed supine position, hip was prepped in sterile
fashion, was entered with a 20 gauge spinal needle. A scant amount of non
inflamm fluid was aspirated.

ARTHROGRAM: Arthrogram pictures were obtained showing appropriate spread
of the contrast. Injection followed.

SuperCoder Answered Thu 27th of September, 2012 15:38:34 PM

" Injection of corticosteroids" qualifies for 20610 here,the codes in question include 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]), 27093 (Injection procedure for hip arthrography; without anesthesia), and 73525 (Radiologic examination, hip, arthrography, radiological supervision and interpretation).

Current CCI edits list 20610 as a Column 2 code of 27093, which means you shouldn't normally report both procedures together if the physician performs the arthrogram and injection on the same hip. The bundle does allow you to report a modifier, however, to differentiate between services in some instances. Check your documentation to determine whether a modifier such as 59 (Distinct procedural service) might be justified.

If you can't report both 20610 and 27093 for the encounter, submit only 27093 with 73525.

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