How To Use CPT Code 20605

CPT code 20605 describes the procedure of arthrocentesis, aspiration, and/or injection in an intermediate 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 20605?

CPT 20605 is used to describe the procedure of arthrocentesis, aspiration, and/or injection in an intermediate joint or bursa without the use of ultrasound guidance. This code is specifically used when a healthcare provider inserts a needle through the patient’s skin and into an intermediate joint or bursa to remove fluid or inject medication for therapeutic purposes.

2. Official Description

The official description of CPT code 20605 is: ‘Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa) without ultrasound guidance.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate anesthesia and sterilization.
2. The provider inserts a needle through the patient’s skin and into the intermediate joint or bursa.
3. Using a syringe attached to the needle, the provider either removes fluid from the joint or bursa or injects medication for therapeutic purposes.
4. If fluid is removed, it may be sent to a laboratory for further examination.
5. The provider applies pressure to stop any bleeding and removes the needle.

4. Qualifying circumstances

CPT 20605 is used when the healthcare provider performs arthrocentesis, aspiration, and/or injection in an intermediate joint or bursa without the use of ultrasound guidance. This procedure is typically performed on joints or bursae such as the temporomandibular joint, acromioclavicular joint, wrist joint, elbow joint, ankle joint, or olecranon bursa. It is important to note that this code should only be used when ultrasound guidance is not utilized during the procedure.

5. When to use CPT code 20605

CPT code 20605 should be used when a healthcare provider performs arthrocentesis, aspiration, and/or injection in an intermediate joint or bursa without the use of ultrasound guidance. 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 20605, the healthcare provider must document the following information:

• Specific joint or bursa targeted for the procedure
• Details of the procedure performed, including whether fluid was aspirated or medication was injected
• Any additional procedures or treatments performed during the same session
• Any complications or adverse reactions experienced by the patient
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 20605, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately report the joint or bursa targeted for the procedure. Additionally, consider any applicable modifiers or guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT 20605 was added to the Current Procedural Terminology system on January 1, 1990. There have been a few changes to the code description over the years, with the most recent change occurring on January 1, 2015.

9. Examples

1. A healthcare provider performing arthrocentesis in the temporomandibular joint to remove fluid from a patient with jaw pain.
2. A provider aspirating fluid from the acromioclavicular joint of a patient with shoulder pain.
3. An injection of medication into the wrist joint of a patient with arthritis.
4. A healthcare provider performing arthrocentesis in the elbow joint to remove fluid from a patient with swelling.
5. An injection of medication into the ankle joint of a patient with chronic pain.
6. A provider aspirating fluid from the olecranon bursa of a patient with bursitis.
7. An injection of medication into the temporomandibular joint of a patient with TMJ disorder.
8. A healthcare provider performing arthrocentesis in the acromioclavicular joint to remove fluid from a patient with a sports injury.
9. An injection of medication into the wrist joint of a patient with carpal tunnel syndrome.
10. A provider aspirating fluid from the ankle joint of a patient with gout.