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Topic: Study the codes for new orthopedics procedures

Ambulatory Surgery Reimbursement Update, June 17, 2008

Take a closer look at some of the newly added orthopedics procedure codes, courtesy of Susan Garrison, PCS, FCS, CPC, CHC, CCS-P, CPC-H, CPAR, executive vice president at Magnus Confidential, Inc., in Dawsonville, GA, who noted the following codes during the April 2 HCPro audioconference, ASC Orthopedic Changes: Confront Coding and Financial Repercussions of the Final Rule.

• 20550: Injection(s), single tendon sheath. If the physician delivers multiple injections into one tendon sheath, report 20550. Documentation must specify the injection area as the tendon sheath: the sleeve that covers and lubricates the tendon.
• 20551: Injection(s), single tendon origin. As with 20550, it does not matter how many times the physician administers injections; report 20551 once. Be sure to note that the injection is into the origin, where the tendon connects to the muscle.
• 20552: Injection(s), single or multiple trigger point(s), one or two muscles.
• 20553: Injection(s), single or multiple trigger point(s), three or more muscles. Trigger points happen when tendons swell at the base of the digit, causing popping and clicking. To correctly report CPT codes 20552 and 20553, you must note the number of muscles, said Garrison. Documentation is important because you have an opportunity to capture multiple codes as long as the physician documents these details and your coders pick up on that information, she added.
• 20600: Arthrocentesis, aspiration, and/or injection; small joint or bursa (for example, fingers and toes).
• 20605: Arthrocentesis, aspiration, and/or injection; intermediate joint or bursa (for example, temporomandibular, wrist, elbow, or ankle).
• 20610: Arthrocentesis, aspiration, and/or injection; major joint or bursa (for example, shoulder, hip, knee joint). “As long as you are acclimated to what that particular joint ... because they don’t list them all, you should be fine,” Garrison said.
• 21076–21088: Impression and custom preparation; multiple types of prosthesis. These describe services for the rehabilitation of patients with oral, facial, or other anatomical deficiencies with prostheseis, such as an artificial eye, ear, or nose, or an intraoral obturator to close a cleft. Only report these codes when the physician is designing and preparing the prosthesis, Garrison said.

Editor’s note: This topic is from the June 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider. For more information about the April 2 HCPro audioconference, “ASC Orthopedic Changes: Confront Coding and Financial Repercussions of the Final Rule,” click here.

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