01/25/2019

Correct Coding for Sinus Tarsi Injection

What is the proper code for sinus tarsi injection?

The correct code is 20605

20605

Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound

Lay Description Code

After administering a local anesthetic, the physician inserts a needle through the skin and into a joint or bursa. A fluid sample may be removed from the joint for examination or a fluid may be injected for lavage or drug therapy. The needle is then withdrawn and pressure is applied to stop any bleeding. Report 20600 for arthrocentesis of a small joint or bursa, such as the fingers or toes, without ultrasound guidance; 20604 for arthrocentesis of a small joint or bursa, with ultrasound guidance, including permanent record and report; 20605 for an intermediate joint or bursa, such as the wrist, elbow, ankle, olecranon bursa, or temporomandibular or acromioclavicular area, without ultrasound guidance; 20606 for intermediate joint or bursa, with ultrasound guidance, including permanent record and report; 20610 for a major joint or bursa injection or aspiration, such as of the shoulder, hip, knee joint, or subacromial bursa, without ultrasound guidance; 20611 for a major joint or bursa, with ultrasound guidance, including permanent record and report.

Coding Tips

These codes should be reported only once even if an aspiration and injection are performed during the same session. Local anesthesia is included in these services. To report imaging guidance, see 77002, 77012, and 77021. Ultrasonic guidance (76942) should not be reported with 20600-20611. Do not report 20600 or 20604 with 0489T-0490T. Do not report 20610 or 20611 with 27369. For aspiration or injection of a ganglion cyst, see 20612. It is inappropriate to report supplies when these services are performed in an emergency room. For physician offices, supplies may be reported with the appropriate HCPCS Level II code. Check with the specific payer to determine coverage.