Report additional services separately for a knee effusion procedure
APCs Weekly Monitor, November 10, 2005
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Report additional services separately for a knee effusion procedure
QUESTION: A patient comes to the ED with knee effusion. The ED physician aspirates the joint (20610) and gives the patient a shot of demerol and phenergan (90782) and rocephin (90788). The final diagnosis is "knee effusion".
Is it appropriate to code all three services? When analgesia is required (i.e., fracture reductions), it seems really obvious. But I am confused as to whether I should report additional services for these lesser procedures.
ANSWER: In this scenario, bill the joint aspiration (20610) and the rocephin injection (90788). We assume also that the ED visit contains the proper documentation to support a separate ED visit code (99281-99285) appended with modifier -25.
The only service which may or may not be separately billable is the demerol and phenergan injection. Since this is likely a general pain control injection-and not sedation analgesia-you can separately code and bill it as 90782. If the injection is for sedation analgesia, bill it as 99141 rather than 90782.
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