New 2015 CPT Codes: All About Arthrocentesis

This post is designed to help students studying medical billing and coding online learn all about the new codes for Arthrocentesis.
Let’s start at the very beginning. What is arthrocentesis?  From medicinenet.com:

Arthrocentesis: A procedure in which a sterile needle and syringe are used to drain fluid from the joint. This is usually done as an office procedure or at the bedside in the hospital. For certain conditions, medication is put into the joint after fluid removal. The needle is then removed, and a bandage or dressing is applied over the entry point. Joint fluid can be examined to determine the cause of the joint swelling, such as infection, gout, or rheumatoid disease. Arthrocentesis can be helpful in relieving joint swelling and pain.

And remember, when fluid is removed it is called an aspiration; when fluids are introduced, we call this an injection.

Last year, there was just one CPT code for each musculoskeletal body area aspirated or injected. Those areas classified as a small joint or bursa, such as the fingers and toes, were assigned code 20600; hose classified as intermediate joint or bursa, such as the temporomandibular, acromioclavicular, wrist, elbow or ankle joint, were assigned code 20605; and a large joint or bursa, such as the shoulder, hip, knee joint or subacromial bursa, was coded 20610. A separate radiology code was used to report if imaging guidance was performed. (Using imaging guidance helps the healthcare provider to see the exact location of the needle while performing the surgery.)

For 2015, the American Medical Association has added new codes to make the distinction of when these procedures are performed with and without ultrasound guidance.  The old codes—20600, 20605, and 20610—are now used to reference an arthrocentesis of each area without ultrasound guidance. There are new codes to specify when these procedures are rendered with ultrasound guidance.

For example, in 2014, CPT code 20600 only referenced an arthrocentesis, aspiration and/or injection; small joint or bursa.  For 2015, code 20600 now references “Arthrocentesis, aspiration and/or injection, small joint or bursa; without ultrasound guidance.”

A new code, 20604, includes with ultrasound,  “Arthrocentesis, aspiration and/or injection, small joint or bursa; with ultrasound guidance, with permanent recording and reporting.”

Likewise there are 2 other new codes for the intermediate and major joint injections with ultrasound guidance: 20606 and 20611.

For more information on this topic, review the article in this month’s Healthcare Business Monthly, “Sharpen Your Joint Aspiration/Injectin Coding” by G.J. Verhovshel.