How To Use CPT Code 20501

CPT code 20501 describes the injection of a diagnostic agent into a sinus tract for diagnostic purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20501?

CPT 20501 is used to describe the injection of a diagnostic agent, such as contrast material, into a sinus tract that connects an abscess in the body to the skin. This procedure helps to identify and locate the extent of inflammation, abscess, cyst, or lesion. The provider may use imaging guidance, such as fluoroscopy, to visualize the procedure.

2. Official Description

The official description of CPT code 20501 is: ‘Injection of sinus tract diagnostic (sinogram).’ This code is used when a provider injects a diagnostic agent into a sinus tract for diagnostic purposes. It is important to note that for radiological supervision and interpretation, a separate code (76080) should be used.

3. Procedure

The procedure for CPT code 20501 involves the following steps:

1. The patient is appropriately prepped and the area is anesthetized.
2. The provider identifies the opening of the sinus tract.
3. A diagnostic agent, such as fluoroscopic dye or contrast material, is injected directly into the sinus tract.
4. Imaging guidance, such as fluoroscopy, may be used to aid in the injection process.

4. Qualifying circumstances

CPT 20501 is typically performed on patients with sinus tracts that connect an abscess in the body to the skin. The procedure helps to identify and locate the extent of inflammation, abscess, cyst, or lesion. It is important to note that this code should not be used for contrast injection and radiological assessment of gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy tubes, as there are separate codes for those procedures (49465).

5. When to use CPT code 20501

CPT code 20501 should be used when a provider performs the injection of a diagnostic agent into a sinus tract for diagnostic purposes. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 20501, the provider must document the following information:

• Patient’s diagnosis and the need for the sinus tract diagnostic
• Specific details of the injection procedure, including the type of diagnostic agent used
• Date and time of the procedure
• Any imaging guidance used, such as fluoroscopy

7. Billing guidelines

When billing for CPT code 20501, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also be aware of any additional codes that may need to be reported in conjunction with CPT 20501, such as radiological supervision and interpretation (76080) if applicable. It is important to follow the guidelines provided by the payer and ensure accurate documentation to support the claim.

8. Historical information

CPT code 20501 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 20501

There are no similar codes to CPT code 20501.

9. Examples

1. A provider injects a diagnostic agent into a sinus tract to identify the extent of an abscess in a patient’s abdomen.
2. A provider uses fluoroscopy to guide the injection of contrast material into a sinus tract to locate the source of inflammation in a patient’s knee.
3. A provider injects a diagnostic agent into a sinus tract to determine the extent of a cyst in a patient’s neck.
4. A provider uses imaging guidance to inject a diagnostic agent into a sinus tract to identify the location of a lesion in a patient’s back.
5. A provider performs a sinogram to visualize the extent of a sinus tract connecting an abscess in a patient’s thigh to the skin.
6. A provider injects a diagnostic agent into a sinus tract to identify the extent of inflammation in a patient’s shoulder.
7. A provider uses fluoroscopy to guide the injection of contrast material into a sinus tract to locate the source of an abscess in a patient’s chest.
8. A provider injects a diagnostic agent into a sinus tract to determine the extent of a cyst in a patient’s arm.
9. A provider uses imaging guidance to inject a diagnostic agent into a sinus tract to identify the location of a lesion in a patient’s leg.
10. A provider performs a sinogram to visualize the extent of a sinus tract connecting an abscess in a patient’s abdomen to the skin.