| Coding Consult | Sprains and Joint Injections |
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Page 2 of 2 Use the appropriate E&M code (99201-99205) with modifier –25 attached if you met the requirements to charge a separate E&M, Brink says. But don't automatically bill an E&M for the follow-up visit, experts say. When the patient comes for the follow-up visit and tells you that her elbow isn't better, but she doesn't have any new symptoms, the situation won't qualify for a separate E&M when you administer a second injection, says Brink. If you're coding a joint injection in a finger, use the "F" modifiers found in your HCPCS book to specify which finger, Acevedo says. This is especially important if you're giving injections in multiple fingers, she explains. For example, say you drain fluid from the joints in a patient's right thumb and right ring finger and inject 20 mg of Depo-Medrol in each finger. You should report 20600 (arthrocentesis, aspiration and/or injection; small joint or bursa [e.g., fingers, toes]) with modifier F5 (right hand, thumb) and append the second 20600 with modifier –59 (distinct procedural service) and modifier F8 (right hand, fourth digit). List J1020-F5 and J1020-F8 for the Depo-Medrol injections in each finger. Coding Consult This information is adapted from material provided by the Coding Institute. For a free sample issue or information on how to subscribe to any of 29 specialty-specific coding newsletters, please contact the Coding Institute, 2272 Airport Road South, Naples, FL 34112; phone 800-508-2582; fax 800-508-2592 or visit www.codinginstitute.com.
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