P Posted Tue 08th of January, 2019 19:57:53 PM
The patient presents today for the third and final Orthovisc hyaluronic acid injection in a series of 3 for the left knee. The patient has agreed to proceed forward. Patient was positioned on the exam table. The left knee was prepped with chlorhexidine solution. Aspiration of the left knee joint was also perfon-ned using 3 cc of quarter percent Marcaine plain with a 25-gauge needle in the tissue to achieve local anesthesia. An 18-gauge needle was used to aspirate 25 cc of benign-appearing, serosanguineous fluid. An ultrasound machine for needle placement was used. Syringes were exchanged and 2 cc of Orthovisc was injected into the left knee joint without difficulty. The patient tolerated the procedure well. Patient was then placed in a prone position. Attention was turned towards the Baker cyst. The posterior knee was prepped with chlorhexidine. An ultrasound machine was used to visualize the cyst which looked filled with debris and lobulated. A 25-gauge needle was used to infiltrate 3 cc of wailer percent Marcaine plain and then an 18-gauge needle was used to attempt aspiration which wasun successful due to the debris in the cyst. About 5 cc of bloody fluid was aspirated. Patient was told to follow-up in 6 weeks for reevaluation. I renewed her Norco prescription.
Our doctor wants to bill 20611 x 2, one for knee injection and one for Baker's cyst aspiration. Can we bill 20611x2?
P Posted Tue 08th of January, 2019 19:58:23 PM
The insurance is Medicare.
SuperCoder Answered Wed 09th of January, 2019 03:56:11 AM
Thank you for your question.
As per the above provided documentation, only one unit of CPT code 20611 will be reported.
There is a connection between the joint and the bursa, so the bursa and the Baker's cyst (a fluid filled bursa) are "extensions" of the joint. Hence, the aspiration of the cyst is intrinsic to a treatment of the knee joint.
Note: When reporting these codes, remember that a unit of service equals a joint and its surrounding bursae (if any).
Hope this helps!
Please feel free to write if you have any question.