How To Use CPT Code 20551

CPT 20551 refers to the injection of a drug into the origin or insertion site of a tendon for pain relief, inflammation, and swelling. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 20551.

1. What is CPT 20551?

CPT 20551 is a medical procedure code used to describe the injection of a drug, such as a corticosteroid, anesthetic, or anti-inflammatory medication, into the origin or insertion site of a tendon. This procedure is performed to relieve pain, inflammation, and swelling caused by a diseased or damaged tendon.

2. 20551 CPT code description

The official description of CPT code 20551 is: “Injection(s); single tendon origin/insertion.”

3. Procedure

The 20551 procedure involves the following steps:

1. The patient is appropriately prepped and the area is anesthetized.
2. The provider prepares the site for injection and may use radiological guidance to identify the tendon origin when it is not possible to visually locate the site of drug delivery.
3. The provider injects the appropriate amount of corticosteroid, anesthetic, or anti-inflammatory drug directly at the tendon origin or insertion.
4. The syringe is withdrawn, and the provider observes the patient for any adverse reaction.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 20551 services are those experiencing pain, inflammation, and swelling due to a diseased or damaged tendon. The provider must determine that the injection of a drug into the tendon origin or insertion site is the most appropriate treatment for the patient’s condition.

5. When to use CPT code 20551

It is appropriate to bill the 20551 CPT code when the provider performs an injection into the tendon origin or insertion site to treat pain, inflammation, and swelling caused by a diseased or damaged tendon. This code should not be used for injections directly into a tendon sheath.

6. Documentation requirements

To support a claim for CPT 20551, the following information should be documented:

• Patient’s medical history and symptoms
• Physical examination findings
• Diagnosis of the diseased or damaged tendon
• Rationale for the injection procedure
• Details of the injection, including the drug used, dosage, and specific tendon origin or insertion site
• Any radiological guidance used during the procedure
• Provider’s observations and patient’s response to the treatment

7. Billing guidelines

When billing for CPT code 20551, keep in mind the following guidelines and rules:

• Report 20551 only one time for single or multiple injections to the same tendon origin or insertion site.
• For injections to multiple different tendon origin or insertion sites, report this code one time for each injection.
• Do not report 20550 or 20551 in conjunction with 0232T or 0481T.
• For harvesting, preparation, and injection(s) of platelet-rich plasma, use 0232T.

8. Historical information

CPT 20551 was added to the Current Procedural Terminology system on January 1, 2002. The code has undergone the following changes:

• Code Changed on 01-01-2004: Previous Descriptor – Injection(s); tendon origin/insertion
• Code Changed on 01-01-2003: Previous Descriptor – Injection; tendon origin/insertion

9. Similar codes to CPT 20551

Five similar codes to CPT 20551 and how they differentiate are:

• CPT 20550: Involves injections into a single tendon sheath, ligament, or aponeurosis, rather than the tendon origin or insertion.
• CPT 20552: Describes injections into a single or multiple trigger points, not the tendon origin or insertion.
• CPT 20553: Refers to injections into three or more muscle groups, not the tendon origin or insertion.
• CPT 0232T: Involves the harvesting, preparation, and injection of platelet-rich plasma, not a corticosteroid, anesthetic, or anti-inflammatory drug.
• CPT 0481T: Describes the injection of amniotic membrane or umbilical cord tissue, not a corticosteroid, anesthetic, or anti-inflammatory drug.

10. Examples

Here are 10 detailed examples of CPT code 20551 procedures:

1. Injection of corticosteroid into the origin of the Achilles tendon for treatment of Achilles tendinitis.
2. Injection of anesthetic into the insertion site of the patellar tendon for pain relief in patellar tendinopathy.
3. Injection of anti-inflammatory medication into the origin of the rotator cuff tendons for treatment of rotator cuff tendinitis.
4. Injection of corticosteroid into the insertion site of the biceps tendon for treatment of biceps tendinitis.
5. Injection of anesthetic into the origin of the extensor carpi radialis brevis tendon for pain relief in lateral epicondylitis (tennis elbow).
6. Injection of anti-inflammatory medication into the insertion site of the tibialis posterior tendon for treatment of tibialis posterior tendinopathy.
7. Injection of corticosteroid into the origin of the gluteus medius tendon for treatment of gluteus medius tendinitis.
8. Injection of anesthetic into the insertion site of the hamstring tendons for pain relief in hamstring tendinopathy.
9. Injection of anti-inflammatory medication into the origin of the wrist flexor tendons for treatment of wrist flexor tendinitis.
10. Injection of corticosteroid into the insertion site of the quadriceps tendon for treatment of quadriceps tendinitis.