04/27/15 – How to report new joint injection codes with fluoro guidance

Question: The new joint injection codes 20604, 20606 and 20611 specify an injection with ultrasound guidance. The other options (20600, 20605 and 20610) specify joint injections with no imaging. Which code do we choose when fluoroscopy is used?


Answer: You should report 77002 (Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device) with any of the injection codes:


  • 20600- Arthrocentesis, aspiration and/or injection, small joint or bursa ( e.g., fingers, toes); without ultrasound guidance


  • 20605- Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance


  • 20610- Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance.





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