Some changes and deletions have been made to anesthesia as well arthrocentesis procedures.
Anesthesia
There are three codes for anesthesia which were deleted due to underuse. This does not mean that the procedure identified will never be used, just that the procedure is not used as often and therefor doesn’t require its own code. If the procedure is still performed, a previous version of the code would be correct to use.
DELETED-00452 Anesthesia for procedures on clavical and scapula, radical surgery.
DELETED-00622 Anesthesia for procedures on thoracic spine and cord, thoracolumbar sympathectomy.
DELETED-00634 Anesthesia for procedures in lumbar region, chemonucleolysis.
Arthrocentesis
Several arthrocentesis codes are revised, and added. The changes were made to these codes to report whether ultrasound guidance was used. Make sure the medical documentation also reports whether ultrasound guidance was or was NOT used. If claims get audited, a lack of notation to whether ultrasound guidance was used will dictate that the correct code needed would be no ultrasound guidance (a code with a smaller reimbursement).
20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting. This is a new code to show guidance was used.
20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20606 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance. This is a new code to show guidance was used.
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance. This is a new code to show guidance was used.
These codes differeniate between using and not using ultrasound guidance. If one of the procedures was done with fluoroscopic, CT, or MRI guidance, you would use the code without ultrasound guidance and the additional code to show the different guidance used.
For example, a physician completed an arthrocentesis of the knee using MRI guidance, the codes to report would be: 20610 and 77021. Also modifiers differentiating right or left need to be on both codes as well as documented in the surgical note.
There are three codes for anesthesia which were deleted due to underuse. This does not mean that the procedure identified will never be used, just that the procedure is not used as often and therefor doesn’t require its own code. If the procedure is still performed, a previous version of the code would be correct to use.
DELETED-00452 Anesthesia for procedures on clavical and scapula, radical surgery.
DELETED-00622 Anesthesia for procedures on thoracic spine and cord, thoracolumbar sympathectomy.
DELETED-00634 Anesthesia for procedures in lumbar region, chemonucleolysis.
Arthrocentesis
Several arthrocentesis codes are revised, and added. The changes were made to these codes to report whether ultrasound guidance was used. Make sure the medical documentation also reports whether ultrasound guidance was or was NOT used. If claims get audited, a lack of notation to whether ultrasound guidance was used will dictate that the correct code needed would be no ultrasound guidance (a code with a smaller reimbursement).
20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting. This is a new code to show guidance was used.
20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20606 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance. This is a new code to show guidance was used.
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance. A revision was made to this code to NOT use ultrasound guidance.
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance. This is a new code to show guidance was used.
These codes differeniate between using and not using ultrasound guidance. If one of the procedures was done with fluoroscopic, CT, or MRI guidance, you would use the code without ultrasound guidance and the additional code to show the different guidance used.
For example, a physician completed an arthrocentesis of the knee using MRI guidance, the codes to report would be: 20610 and 77021. Also modifiers differentiating right or left need to be on both codes as well as documented in the surgical note.
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