How To Use CPT Code 20600

CPT 20600 describes the procedure of arthrocentesis, aspiration, and/or injection in a small joint or bursa without ultrasound guidance. 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 20600?

CPT 20600 is used to describe the procedure of arthrocentesis, aspiration, and/or injection in a small joint or bursa without the use of ultrasound guidance. This code is specifically for the treatment of small joints or bursae, such as those in the fingers or toes. The procedure involves the insertion of a needle into the joint or bursa to remove fluid or inject medication for therapeutic purposes.

2. Official Description

The official description of CPT code 20600 is: ‘Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes) without ultrasound guidance.’

3. Procedure

In the procedure of CPT 20600, the healthcare provider inserts a needle through the skin and into the small joint or bursa without the use of ultrasound guidance. The provider then uses a syringe attached to the needle to either remove fluid from the joint or bursa through aspiration or inject medication for therapeutic purposes. After the procedure, the needle is removed, and pressure may be applied to stop any bleeding. It is important to note that ultrasound guidance is not used during this procedure.

4. Qualifying circumstances

CPT 20600 is performed on patients who require arthrocentesis, aspiration, and/or injection in a small joint or bursa. This procedure is typically used for conditions affecting small joints or bursae, such as those in the fingers or toes. The decision to perform this procedure is based on the patient’s clinical presentation and the healthcare provider’s assessment of the need for joint fluid aspiration or medication injection. It is important to note that ultrasound guidance is not used during this procedure.

5. When to use CPT code 20600

CPT code 20600 should be used when a healthcare provider performs arthrocentesis, aspiration, and/or injection in a small joint or bursa without the use of ultrasound guidance. This code is specifically for small joints or bursae, such as those in the fingers or toes. If the procedure is performed on larger joints or bursae, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 20600, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for arthrocentesis, aspiration, and/or injection
• Specific joint or bursa targeted for the procedure
• Date of the procedure
• Procedure details, including whether it involved aspiration or injection
• Medication injected, if applicable
• Any complications or adverse reactions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 20600, ensure that the procedure is performed on a small joint or bursa without the use of ultrasound guidance. It is important to accurately document the procedure details and any medications injected, if applicable. CPT code 20600 should not be reported with other codes for larger joints or bursae. Follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 20600 was added to the Current Procedural Terminology system on January 1, 1990. There have been a few changes to the code over the years, with the most recent change occurring on January 1, 2015. The code was previously described as ‘Arthrocentesis, aspiration and/or injection small joint or bursa (eg, fingers, toes).’ The historical changes reflect updates in terminology and specificity.

9. Similar codes to CPT 20600

There are several similar codes to CPT 20600 that describe arthrocentesis, aspiration, and/or injection procedures in different joints or bursae. Some examples include:

• CPT 20605: Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
• CPT 20610: Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
• CPT 20612: Aspiration and/or injection of ganglion cyst(s) any location
• CPT 20615: Aspiration and/or injection of bone cyst
• CPT 20650: Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) with ultrasound guidance, with permanent recording and reporting

9. Examples

1. A healthcare provider performs arthrocentesis on a patient’s finger joint to remove fluid for diagnostic purposes.
2. A patient with a toe bursitis receives an injection of medication into the affected bursa for therapeutic purposes.
3. A healthcare provider performs arthrocentesis on a patient’s finger joint to inject a corticosteroid for the treatment of inflammation.
4. A patient with a toe joint effusion undergoes arthrocentesis to remove excess fluid and relieve pain.
5. A healthcare provider performs arthrocentesis on a patient’s finger joint to inject a hyaluronic acid derivative for the treatment of osteoarthritis.
6. A patient with a toe bursitis receives an injection of a local anesthetic into the affected bursa for pain relief.
7. A healthcare provider performs arthrocentesis on a patient’s finger joint to remove fluid and relieve pressure caused by an infection.
8. A patient with a toe joint effusion undergoes arthrocentesis to remove fluid and improve joint mobility.
9. A healthcare provider performs arthrocentesis on a patient’s finger joint to inject a platelet-rich plasma for the treatment of a ligament injury.