Cpt 20611. I would use separate Dx codes for each.

Cpt 20611 Example: Using US guidance for CPT code 20611 is for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa using ultrasound guidance. Medical Necessity Aetna considers ultrasound (US) guidance medically necessary for the following procedures (not an all-inclusive list): Adductor canal nerve block Arterial line placement Aspiration of tubo-ovarian abscess Axillary brachial plexus nerve block Baker's cyst, after failure May 4, 2025 · How do I know if a CPT code is bilateral? If the code has an indicator of two, it is a bilateral procedure code. CPT code 20611 is for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa using ultrasound guidance. Unlock the essentials of 20610 CPT code for accurate medical billing and maximize your reimbursement with our expert guidance and tips. Cysts may be located in various anatomical sites, including the breast, skin, liver, thyroid, kidneys, or joints. For example, if arthrocentesis is performed on the shoulder and hip joint, the 20610 and 20610-59 modifiers can be coded Mar 19, 2023 · Use this page to view details for the Local Coverage Article for Billing and Coding: Sacroiliac Joint Injections and Procedures. Overview This Coverage Policy addresses miscellaneous musculoskeletal procedures, including but not limited to articular cartilage repair (other than the knee joint), ligament/meniscus reconstruction, intra-articular joint injections, and thermal capsular shrinkage. One was used for diagnostic purposes and one was used with the procedure. CPT code 20610 is used Coverage Rationale Gel-One, GenVisc 850, Hyalgan, Hymovis, Monovisc, Orthovisc, Supartz, Synojoynt, Synvisc or Synvisc-One, Triluron, TriVisc, and Visco-3 are typically excluded from coverage. CPT 20604 Definition of CPT 20604: Arthrocentesis, aspiration and/or injection, small joint or bursa (e. , CPC, CPC-P, CEMC, CPMA, CRHC, CCS-P Coding for joint arthrocentesis, aspiration, or injection can be difficult, but following a few simple rules and pulling your coding resources together can make it easier. Unless your payer requires Apr 19, 2018 · Question: Our sports medicine physicians are reporting diagnostic ultrasounds (76881) and ultrasound guided injections at the same session, same joint. For example, if arthrocentesis is performed on the shoulder and hip joint, the 20610 and 20610-59 modifiers can be coded Jun 11, 2023 · Use this page to view details for the Local Coverage Determination for Intraarticular Knee Injections of Hyaluronan. The code is billed twice because this was a bilateral procedure. IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission of accurate claims. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17. It would be incorrect coding, and contradictory, to bill 20610 with 76942 because the description for 20610 specifically states 'without ultrasound guidance'. THIS PROCEDURE WAS REPEATED SEVERAL TIMES WITH A MIXTURE OF 1% LIDOCAINE AND STERILE SALINE UNTIL VISIBLE Oct 1, 2015 · Use this page to view details for the Local Coverage Article for Billing and Coding: Pain Management - injection of tendon sheaths, ligaments, ganglion cysts, carpal and tarsal tunnels. 20611 RT M17. 41 Coding/Billing Rationale ad goes here:advert-2ADVERTISEMENTSCROLL TO CONTINUENo evaluation and management (E/M) code was added because there was no significant and/or separate identifiable reason for an E/M service to be billed with this scheduled visit for her series Aug 21, 2022 · Use this page to view details for the Local Coverage Article for Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis. Place the CPT code 20610 in item 24D. CPT: 20611-RT, J1040, 89060 ad goes here:advert-1ADVERTISEMENTSCROLL TO CONTINUEICD-10: M17. Aug 30, 2021 · 20611, per the CPT description, is the correct code if the procedure is performed with ultrasound guidance. , shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). Their policy for Aetna MA are pointing to a commercial policy Jan 25, 2017 · CPT: 20611-LT, J7325 X 1 ICD-9: 715. 11 next line 20611, XS, Lt w/ M25. CPT® Code 20611 | Case2Code Nov 16, 2016 · Take the challenge. 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (e. The aspiration and/or injection procedure code may be billed in addition to the drug. 31. 20611 vs Unlisted Barbatage Mar 7, 2025 · Can you bill an office visit with a joint injection? Answer: Unfortunately, no. , fingers, toes); with ultrasound guidance, 5 days ago · CPT® Code 20611 in section: Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa) 20610-20611 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance 20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting We would like to show you a description here but the site won’t allow us. In coding scenarios where there appears to be conflicts between sources, we will apply the edits we determine are appropriate. Coding for arthrocentesis can be complex. The procedure may be performed for diagnostic analysis Nov 12, 2025 · AMA CPT ® Assistant - 2015 Issue 2 (February) Arthrocentesis (Codes 20600-20611) (February 2015) February 2015 pages 6-8 Arthrocentesis (Codes 20600-20611) For safety and better patient outcomes, ultrasound as an imaging technology is often used in musculoskeletal medicine as an extension of the physical examination for accuracy of intra-articular placement of the needle. For Zilretta injectable for Medicare members, see Medicare Part B Criteria. The aspiration may be diagnostic (e. Key Components of Knee Abscess Management Clinical Evaluation Dec 1, 2020 · Laterality Matters When reporting codes for unilateral joint arthrocentesis, the use of modifier RT or LT on the injection procedure (e. Based on feedback from Healthcare Business Monthly readers, and what we hear on AAPC Member Forums, one such “problem code” is 20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee Coverage Rationale UnitedHealthcare members may choose to receive surgical procedures in an ambulatory surgical center (ASC) or other locations. CPT or HCPCS codes with bilateral in Nov 1, 2017 · Utilize all the code sets, plus modifiers, to wholly capture physicians’ services. Procedure note: The right SASDB and above-described calcification were evaluated under ultrasound using a 12mHz linear array transducer. The physician’s procedure note does not fully detail the ultrasound guidance, other than the ultrasound Aug 15, 2017 · If the provider performs joint aspiration/injection with US guidance, select 20604, 20606, or 20611 (depending on the joint targeted). determine the role of intraarticular hyaluronic acid products in the treatment of acute ankle sprains. 512 (Lt Shoulder) Provided performed both on the same visit. Sacro-iliac joint/nerve denervation procedures are also considered investigational and not medically necessary. 12 This claim is rejected by the insurance carrier because the injection was outside of the preauthorization window that ended on Oct. Jul 15, 2025 · CPT 20611 describes joint injection with ultrasound guidance, enabling accurate treatment delivery, improved patient care, and streamlined billing processes. When To Use CPT 20611 CPT code 20611 is used when a healthcare provider performs arthrocentesis on a major joint or bursa with the aid of ultrasound guidance. 0) and secondary: Knee Joint Pain (M25. "BARBOTAGE WITH 1% LIDOCAINE WAS PERFORMED AND ASPIRATION OF CALCIFIC CRYSTALS FROM THE DEPOSIT WAS NOTED. UnitedHealthcare reimbursement policies may use Current Procedural Terminology (CPT®*), Centers for Medicare and Medicaid Services (CMS Jul 25, 2018 · Certain medical conditions, injuries, and infections can cause joint effusion or build up of intraarticular fluid. Review description and fee schedules for CPT Code 20611, intended for Surgery, and compare rates across different payers. Consult with your program director and CMS to determine whether you should use HCPCS Level I, or CPT, as your code system for your value set. I would use separate Dx codes for each. This month’s tip comes from G. We would like to show you a description here but the site won’t allow us. , shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement Use this page to view details for the Local Coverage Article for Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma. Arthrocentesis can be found in the musculoskeletal section of the CPT code book in the 20600–20611 series. Sometimes they are denied, but easily corrected with the carrier. ' Jan 10, 2023 · 77021 Magnetic resonance guidance for needle placement (Eg: For biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation. We have had some success with medical necessity on appeals, but Aetna Medicare has been denying this as well. g. It is a procedure performed to collect synovial fluid from joint spaces for the identification of a disease process or the relief of painful or bothersome symptoms. i just learned that you have to apply -EJ to the drug code for subsequent visits or both the injection and drug code will deny. The ultrasound guided injections (20604, 20606 and 20611) include ultrasound image guidance in the definition of the Discover everything about cpt code for viscosupplementation injection. . For the Current Aug 17, 2020 · Hello, If some one could help me, I coded 20611 with 17. May 1, 2021 · Hello all. 562) CPT Codes: 20610 (unilateral), add 77002 if you perform under Fluoroscopy 20611 (unilateral) - if you perform under ultrasound If the injecti Use CPT code 64999 (Unlisted procedure, nervous system) for pulsed radiofrequency and the denervation procedures of the sacro-iliac joint/nerves. Some insurance carriers require the CPT codes to be submitted with an LT/RT modifier while others accept May 30, 2017 · If the provider performs joint aspiration/injection with US guidance, select 20604, 20606, or 20611 (depending on the joint targeted). 20551, or using both with a modifier on 20551. Refer to the Medical Benefit Drug Policy titled Medical Benefit Therapeutic Equivalent Medications CPT 20610 can be reported for a major joint or bursa injection or aspiration without ultrasound guidance. Indicate which knee was injected by using the RT (right) or LT (left) modifier (FAO-10 electronically) on the injection procedure (CPT 20610). 0232T includes the administration of the injection, harvesting the PRP, and imaging guidance. For example, a patient presents to the office for an injection of 40 mg of triamcinolone to the right hip for trochanteric bursitis of the right hip. I am in KY CGS is my MAC. ad goes here:advert-2ADVERTISEMENTSCROLL TO CONTINUENote: Although the injection Arthrocentesis & Injection FAQYes, arthrocentesis or injections are classified based on the location of the joint or bursa as small, intermediate, or major. New Feb 17, 2018 · Coding Rationale The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e. Use official Procedure Price Lookup tool to compare national average to Medicare costs in ambulatory surgical centers, hosptial outpatient departments Nov 1, 2018 · Our physician performed a shoulder joint injection with ultrasound guidance. 12—Unilateral primary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e. Injections reduce pain and inflammation in a joint, tendon, or Apr 27, 2017 · A physician in our group is taking the patient to the surgery center for a hip injection using fluoroscopy. It is true that an evaluation and management code, an E/M or office visit, can be reported with a minor procedure such as an injection, but only if the E/M is significant and separate and exceeds the “pre-service evaluation” that is inherent to the injection. John Verhovshek, the managing editor for AAPC CPT code 20611 is for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa using ultrasound guidance. 3. I understand that can be ok when it is a "significant Nov 9, 2018 · We routinely bill out PRP injections in the Orthopaedic practice in which I am employed. Learn billing, documentation, and coding for optimal care. Does that mean I can’t bill both if I do both at the same encounter? Nov 4, 2020 · Hi, Does anyone know if Medicare has guidelines for CPT 20611? I am trying to find a list of covered diagnosis since some payers that are following Medicare's guidelines are denying this code but I cant seem to find anything on the CMS website. Learn the details, modifiers, coding alerts, and forum discussions for this code. , CPT® 20610) may be appropriate to indicate which knee was injected. Medical Necessity Aetna considers the following medically necessary: Arthroscopic knee surgery (with or without partial meniscectomy or meniscal repair) for persons May 25, 2022 · Please note this question was answered in 2022. 0 ad goes here:advert-1ADVERTISEMENTSCROLL TO CONTINUECoding Rationale CPT Codes: 20610-LT, J7325x16 ICD-10 Code: M17. , hand, hip, ankle, shoulder osteoarthritis, temporomandibular joint [TMJ], adhesive capsulitis of the shoulder, subacromial impingement). Both arthrocentesis and injection are included in the below CPT codes: 20600 – Small joint or bursa (fingers, toes), without ultrasound guidance 20605 – Intermediate joint or bursa (TMJ, acromioclavicular, wrist, elbow, able, olecranon Mar 7, 2016 · CPT® 20610 Arthrocentisis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance describes aspiration (removal of fluid) from, or injection into, a major joint (defined as a shoulder, hip, knee, or subacromial bursa)—or both aspiration and injection of the same joint. Can CPT 99214 and 20610 be billed together? You need Jul 13, 2022 · These injections are crossing over to primary: OA (eg. 561, M25. Also, I’d note that modifier 51 on 20611 is incorrect and unnecessary since only one surgical Mar 29, 2019 · Can anyone offer any insight on billing injections for Aetna with 20611 for ultrasound guidance? Aetna denies 20611 every time per their policy that it's experimental. , for cytology or culture) or therapeutic (e. This was all done percutaneously under US guidance. Policy Scope of Policy This Clinical Policy Bulletin addresses viscosupplement (hyaluronate) products for commercial medical plans, and ancillary services. EmblemHealth uses industry-standard claims editing Jun 4, 2025 · We are seeing Aetna denials for 20611 as experimental. Coding is not easy, but some codes seem to cause more than their share of confusion. However, when performing joint aspiration on two different small or major joints, we must use a 59 modifier with any of the CPT. Jun 19, 2025 · Know about orthopedic billing and coding for joint injections and surgeries with expert tips, CPT codes, modifiers, and documentation guidelines. Code 76942 may be reported with modifier 59 if the ultrasonic guidance for needle placement is unrelated to the laparoscopic liver tumor ablation procedure. Key Differences CPT codes 20610 and 20611 are used for joint or bursa injections and aspiration. Coverage reviews may be in place if required by law or the benefit plan. Note: Requires Precertification: Precertification of viscosupplementation products are required of all Aetna participating providers and members in applicable EmblemHealth follows coding edits that are based on industry sources, including, but not limited to; CPT® guidelines from the American Medical Association, specialty organizations, and CMS including NCCI and MUE. The charge, if any, for the drug or biological must be included in the physician's bill and the cost of the drug or biological must represent an expense to the physician. In simple terms, it refers to a medical procedure in which a healthcare provider treats joint pain by inserting a needle into a major joint or bursa (a fluid-filled sac cushioning spaces between bones, muscles, and other tissues). The choice of CPT code depends on the AA Spine and Pain Clinic is the first and largest integrated, private specialty clinic practice of its kind serving both Anchorage and Fairbanks Alaska. Why can I not bill for the diagnostic complete US on the LT shoulder? The Provider is not reimbursed for his work on the diagnostic test? Oct 10, 2022 · Please note this question was answered in 2022. The prescribing information for these agents What is CPT Code 20611 CPT code 20611 is for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa using ultrasound guidance. Range CPT 20500 until CPT 20705 can be used for procedures general introduction or removal procedures on the musculoskeletal system Apr 3, 2025 · What are the billing guidelines for 20610? The procedure code (CPT code) 20610 or 20611 may be billed for the intraarticular injection. Per the CPT book and CCI edits, 0232T should not be billed with CPT 20611. 20610 CPT Code Description Without ultrasound guidance, the 20610 CPT code is billed for a major joint or bursa CPR’s “Coding Corner” focuses on coding, compliance and documentation issues relating specifically to physician billing. Mar 11, 2019 · There is an edit with CPT 20611 and CPT 20550 it states that the codes can be billed together with a modifier. The right subacromial region was then prepped with Mar 15, 2021 · Can you please help me on how to code this? I'm going back and forth on 20611 vs. CPT code 20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting should be reported Feb 16, 2017 · A trigger point injection and a joint injection are bundled by Medicare. " CPT code 76942 should not be reported and modifier 59 should not be used if the ultrasonic guidance is for needle placement for the laparoscopic liver tumor ablation procedure. Arthrocentesis (Codes 20600-20611) For safety and better patient outcomes, ultrasound as an imaging technology is often used in musculoskeletal medicine as an extension of the physical examination for accuracy of intra-articular placement of the needle. Has anyone had any luck with appealing these with Aetna or is this a true denial. The physician should document a complete description of the procedure performed in Knee injections for abscess management involve procedures such as aspiration, incision and drainage (I&D), and corticosteroid injections for associated inflammation. Aug 30, 2016 · Hi All, I really need some help with this one. Nov 14, 2023 · CPT Code 20611 is used for arthrocentesis procedures involving major joints or bursae, such as the shoulder, hip, or knee. Use CPT code 20552, one unit, for unilateral or bilateral sacroiliac joint injection (s). Our sports We can use the 50 along with procedure CPT codes 20600, 20604, 20605, 20606, 20610, and 20611 to code bilateral joint aspiration on both sides. You can bill both and get reimbursed. If the outpatient hospital department is May 22, 2023 · CPT 20611 already includes ultrasound guidance of the injected joint so if your provider is billing 76881 for that same joint, then Medicare’s denial is correct. The following codes should be Jun 2, 2022 · When my provider wants to bill CPT 20611 does the documentation have to exactly say "with permanent recording and reporting"? Policy Scope of Policy This Clinical Policy Bulletin addresses selected treatments for osteoarthritis of the knee (with or without meniscal tears). I would suggest clarifying with your provider if another distinct and separate injection was performed and if not just explaining that The treating physician or primary care provider must submit to EmblemHealth, or ConnectiCare, as applicable (hereinafter jointly referred to as “EmblemHealth”), the clinical evidence that the member meets the criteria for the treatment or surgical procedure. 512 Medicare denied saying that It has to be on one line. 20610 76942 vs 20611 CPT 20611 CPT 20611 - Arthrocentesis, aspiration and/or injection into, a major joint or bursa (eg, shoulder, hip, knee, or subacromial bursa); with ultrasound guidance, with permanent recording and reporting – New code for 2015 Mar 15, 2025 · Score: 5/5 (8 votes) The appropriate site modifier (RT or LT) must be appended to CPT code 20610 or CPT code 20611 to indicate if the service was performed unilaterally and modifier (-50) must be appended to indicate if the service was performed bilaterally. CPT: 20611-LT, J7325-EJ ad goes here:advert-1ADVERTISEMENTSCROLL TO CONTINUEICD-10: M17. Nov 7, 2022 · Findings: Moderate sized calcific lesion was seen which was continuous with the supraspinatus tendon. The other coder and myself have coded things the same in the past, but we have recently had others start questioning how we are doing things. CPT® Categorizes Codes Arthrocentesis, aspiration, or injection is the process Dec 1, 2014 · CPT code 20611 is one of the new code changes in the 2015 CPT. I recommend adding a modifier (51 or 59) to CPT 20550 and see if your claim gets paid. Without this documentation and information, EmblemHealth will not be able to properly review the request preauthorization or post We can use the 50 along with procedure CPT codes 20600, 20604, 20605, 20606, 20610, and 20611 to code bilateral joint aspiration on both sides. For the Current Procedural Terminology (CPT®) 2015 code set, three new codes and three revised codes were created for arthrocentesis. The doctor uses a Policy Scope of Policy This Clinical Policy Bulletin addresses ultrasound guidance for selected indications. Overview Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes on the UnitedHealthcare Bilateral Eligible Procedures Policy List describe unilateral procedures that can be performed on both sides of the body during the same session by the Same Individual Physician or Other Qualified Health Care Professional. Aspiration of a cyst is a common minor procedure performed to remove fluid or semi-solid content from a cystic structure. 12, E66. Fluids are removed for diagnostic and therapeutic purposes. M17. If 76881 was performed on a different joint from the one involved in 20611, then you would need a modifier on 76881 to indicate this. Most insurance carriers enforce their Acute Ankle Sprain. If a patient comes in with Lt knee pain and Mar 7, 2025 · CPT Code 20610 – Description So, what exactly does this code cover? CPT code 20610 is widely used in rheumatology and orthopedics billing. Oct 1, 2015 · Use this page to view details for the Local Coverage Article for Billing and Coding: Hyaluronans Intra-articular Injections of. This code should be reported when the procedure involves both aspiration of fluid and/or injection of medication into the joint space. Answer: Thanks for your inquiry. Do you need modifier 25 with 96372? required for the Injection service, Modifier 25 may Jun 1, 2014 · Answer three common uncertainties when reporting joint aspiration and/or injection. For Medicare criteria for viscosupplementation, see Medicare Part B Criteria. The coding advice may or may not be outdated. Modifier RT, LT, 50, 59 and JW can be needed to report the 20610 CPT code properly. We are conducting site of service medical necessity reviews, however, to determine whether the outpatient hospital department is medically necessary, in accordance with the terms of the member’s benefit plan. Doctors from diverse medical specialties work together in our center to care for patients, and are joined by common information systems and a philosophy that 'the needs of patient come first. thought I would post this Jun 27, 2025 · This guide provides an in-depth look at the most relevant CPT code for Joint Injections, their applications, billing best practices, and key considerations for medical professionals. 01, Z68. We know CPT code 20611 includes ultrasound guidance but is fluoroscopy also… Jul 1, 2016 · We have had a debate going on in our office regarding proper coding of 99213 office visit with an injection. We are receiving denials as inclusive and are not understanding why they are being denied. 60. Apr 15, 2020 · My question is, the Provider preformed a complete ultrasound shoulder exam on the left shoulder-then proceeded with a major joint injection using US w/steroid. Any help would be appreciated! Apr 30, 2015 · Medicare guidelines say that 76942 is no longer a valid code. 16—Osteoarthritis, localized, primary, lower leg ICD-10: M17. The key distinction is in imaging guidance. Choosing the correct CPT code depends on factors such as the method used, imaging guidance, and whether the procedure is performed in a clinical or surgical setting. If the drug was administered bilaterally, a -50 modifier should be used with 20610. Pulsed radiofrequency for denervation is considered investigational and therefore, not medically necessary. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. By Dawson Ballard, Jr. Osteoarthritis and Other Pathologic Conditions Involving Joints Other than the Knee (e. Feb 1, 2019 · Pay close attention to new CPT documentation and coding guidance for reporting radiological imaging. Would I bill it as one line, 20611, 50 Jan 17, 2019 · Take the challenge. 20611, 20606, and 20604 are to be used instead. , fingers, toes); without ultrasound guidance Mar 19, 2018 · Take the challenge. 11 Coding Rationale Keep in mind, no evaluation and management services are billed because there wasn’t a separate and/or significant reason, other than the knee injection, addressed during the visit. There are a total of six changes to this group of codes (20600–20611). Jun 1, 2024 · Summary of Changes: Added statement under Coding Guidance, "For sacro-iliac joint injections performed without CT or fluoroscopic guidance in patients who are not pregnant and who do not have contrast allergies, do not bill CPT codes 27096, 20610, or 20611. A code with this indicator lets the insurance company know that both sides were done. You would not need to add a modifier 50 because the code is already bilateral. No other payer has this denial. , to relieve pressure or pain). 76 and for non-facility charges $65. If you are having trouble getting 20610 or 20611 paid for subsequent injections this is going to help. Claims will be processed at 100% of the allowable. Arthrocentesis involves performing joint aspiration/injections to establish a diagnosis, relieve discomfort, remove infected fluid, or inject medication. CPT 20610 vs 20611: What is the Difference This section compares CPT 20610 and 20611 to assist healthcare practitioners, coders, and billing experts in selecting the appropriate code for joint aspiration or injection treatments. What is CPT Code 20611 CPT code 20611 is for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa using ultrasound guidance. Arthrocentesis is a medical procedure that involves fluid aspiration and/or injection from a joint space using a needle. The reimbursement rate for facility charges is $46. CPT Code 20611 is a medical procedural code for inserting a needle into a joint or bursa and removing fluid or injecting a drug. For example, a new paragraph titled “Imaging Guidance” in both the surgery and medicine guidelines advises that even when imaging guidance or supervision are included in a surgical procedure code, you must still follow the radiology documentation requirements in the CPT manual. Our Sports Med guy keeps billing 20610/20611 cortisone injections along with pretty high E/M services. I have been in the medical field for 10+ years but am newly certified in coding, so I would like to come at this problem with as much data and references as I can to support my perspective. CPT Code 20611 Medicare Reimbursement Medicare does reimburse for CPT code 20611, which refers to the drainage or injection of a joint or bursa with ultrasound guidance. This code specifically indicates that the procedure was performed with the assistance of ultrasound to ensure accuracy and effectiveness. Mar 24, 2016 · 20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting If the provider performs joint aspiration/injection with the aid of US guidance, code application is straightforward: Select 20604, 20606, or 20611, depending on the joint targeted. (Just as sometimes with 2 large joint injections one is denied as HCPCS Level I: CPT codes are identical to a subset of CPT codes. 11 (Rt knee) and 20611 M25. xkk qlynz voyrmsng ekt nhwey mgjo rbkxnu qbsduchs vtxbbo jgbgnc whigf glroun ftos yafwe euxklm