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.
Note: Although the injection was performed via ultrasound guidance, CPT code 76942 should not be billed with the joint injection. As of January 2015, new procedure codes for joint injection with ultrasound guidance are in effect. The new codes are:
- 20604—Arthrocentesis, aspiration and/or injection, small joint or bursa (e.g., fingers, toes); with ultrasound guidance, with permanent recording and reporting.
- (do not report 20600, 20604 in conjunction with 76942)
- 20606—Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow, ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting.
- (do not report 20605, 20606 in conjunction with 76942)
- 20611—Arthrocentesis, aspiration and/or injection, large joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting.
- (do not report 20610, 20611 in conjunction with 27370, 76942)
J1040 is for injection, methylprednisolone acetate 80 mg. The lidocaine is considered incident to the injection; therefore, there is no reimbursement for this drug.
89060 is for the crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine). This can be done in a practice only if they have acquired a Clinical Laboratory Improvement Amendments (CLIA) certificate.
For questions or additional information on coding and documentation guidelines, contact Melesia Tillman, CPC-I, CPC, CRHC, CHA, at [email protected] or 404-633-3777 x820.
