Colleen Posted Thu 17th of January, 2019 21:37:40 PM
I have a doctor that is wanting to code a glenohumeral joint injection with ultrasound (20611) and a subacromial space injection without ultrasound (20610) of the same shoulder. But it's to my understanding that only one injection can be coded per shoulder regardless of how many injections given in same shoulder. His argument is that " we are not injecting the same structure. We are accurately guiding needles using an ultrasound machine to 2 different structures. I was under the impression that this CMS guidelines only applied to the same code (ie you could only bill 20611 once). Your telling me even though using 2 separate codes we still cannot bill for 2 injections?" So with that being said, I can't seem to find anything that states you cannot code both codes in same shoulder. Can you please help clarify the coding in this scenario? If these cannot be billed together, which one would be billed? I'm assuming the 20611.. please advise. I'd appreciate it. Thanks!
SuperCoder Answered Fri 18th of January, 2019 10:05:15 AM
Thanks for your question.
In scenario, where the physician treat the same joint twice, only one injection/aspiration code should be applied. Since ultrasound was used for guidance therefore code 20611 is appropriate to be used.
Hope this helps.