In AAPC discussion forums, there is a reply to a question from 2010 that says “A few years ago, I asked members of the American Academy of Orthopaedic Surgeons’ (AAOS) Coding Committee about separate reporting of injection codes to the shoulder during the same treatment session (., 20610 to the glenohumeral joint and 20605 to the acromioclavicular joint). In general, they agreed that separate billing could be warranted if separate needles were used. In the shoulder, the AC and GH joints are separated by the joint capsule. By contrast, in the knee, once the solution is injected it will cover the medial, lateral and patellofemoral compartments.” With CMS saying a joint is a joint, would injecting both areas in the shoulder constitute one billed major joint injection or two?
When reporing facet joint codes, you may not bill separately for the image guidance. Whether using fluoroscopy or computed axial tomography, guidance is required. If ultrasound guidance is used for the above procedures, the CPT® codebook states that you must report the facet joint injection using 0213T-0218T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance… . If no imageing is used, you must report 20552-20553 Injection(s); single or multiple trigger point(s)….