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Interspinous Ligament Injection
Our doctor performed a interspinous Ligament injection L3-4 for diagnosis Lumbar interspinous bursitis. I billed 20550 but was not able to code anatomical modifier Lt or RT because it was directly injected into the ligament. Would CPT code 22899 be more appropriate as 20550 requires an anatomical modifier?
Question:
Our doctor performed an interspinous Ligament injection L3-4 for the diagnosis of lumbar interspinous bursitis. I billed CPT 20550 but was unable to code the anatomical modifier LT or RT because it was injected directly into the ligament. Would CPT code 22899 be more appropriate, as 20550 requires an anatomical modifier?
Answer:
If an interspinous ligament injection is performed due to bursitis, the correct CPT code would be 20550. Unlisted CPT codes are utilized when a specific CPT code does not exist.
A specific CPT code exists for this procedure therefore, 20550 is used.
*This response is based on the best information available as of 04/02/26.
Nerve Transection CPT 64772
How do I code an AIN and/or PIN Neurectomy?
Question:
How do I code an AIN and/or PIN Neurectomy?
Answer:
You're question is excellent timing. CPT code 64772 Transection or avulsion of other spinal nerve, extradural is used for an AIN and/or PIN Neurectomy. In January 2026, CMS increased the MUE (medically unlikely edit) for 64772 from 2 units to 6 units.
*This response is based on the best information available as of 03/05/26.
CMC Joint Injections
My hospital coder recently told me that I should not bill CMC injections as 20605 but rather 20600. I remember during the conference that 20605 is a justifiable code for thumb CMC joint injections. Can you verify that this is correct and offer me some guidance on what to present to the hospital coder?
Question:
My hospital coder recently told me that I should not bill CMC injections as 20605 but rather 20600. I remember during the conference that 20605 is a justifiable code for thumb CMC joint injections. Can you verify that this is correct and offer me some guidance on what to present to the hospital coder?
Answer:
Thank you for your question. The current guidance, based on an AMA CPT Assistant from August of 2017, is an injection into the CMC joint is 20600.
*This response is based on the best information available as of 02/05/26.
X-Ray Coding: Is it the Hip or the Pelvis?
Can someone please answer the question of if the AP pelvis view is counted as a few when coding hip codes. For example, AP pelvis then 2 individual pictures of each hip AP & Lat; would this be coded as a 73523 (1V pelvis + 2V LT + 2V RT) or would this be coded as 73521 (AP and Lateral Views)? How would you code AP pelvis and 1V of LT Hip? 73501 since it is 1V Hip including AP Pelvis or 73502? There is conflicting information about whether you count the Pelvis as a view and whether you count the individual views done for each side.
Question:
Can someone please answer the question of if the AP pelvis view is counted as a few when coding hip codes? For example, AP pelvis then 2 individual pictures of each hip AP & Lat; would this be coded as a 73523 (1V pelvis + 2V LT + 2V RT) or would this be coded as 73521 (AP and Lateral Views)? How would you code AP pelvis and 1V of LT Hip? 73501 since it is 1V Hip including AP Pelvis or 73502? There is conflicting information about whether you count the Pelvis as a view and whether you count the individual views done for each side.
Answer:
Thank you for reaching out. If you are performing AP pelvis then 2 individual pictures of each hip AP & Lat; you would code 73523 Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views. This is consistent with the AMA's Clinical Examples in Radiology guidelines from fall of 2015.
*This response is based on the best information available as of 01/22/26.
Help! Can You Clarify Radiology Documentation Requirements?
We are just looking for clarification of the Interpretation for Radiology services. We have been including them in our E/M notes for years. Can you please explain exactly what it is payors like UHC are requesting/requiring? Are they wanting a report of that Radiology exam on a separate form altogether?
Question:
We are just looking for clarification of the Interpretation for Radiology services. We have been including them in our E/M notes for years. Can you please explain exactly what it is payors like UHC are requesting/requiring? Are they wanting a report of that Radiology exam on a separate form altogether?
Answer:
You're not the only one who has been including the interpretation in the E/M.
CPT guidelines in the introductory section of the radiology chapter 70000-79999 states a written report signed by the interpreting individual is considered "an integral part of a radiologic procedure or interpretation." This means radiology interpretation requires formal, separate documentation—not just findings mentioned within an E/M note. The written report must contain interpretive findings and documentation of the imaging performed.
The CPT exception is if the CPT code includes imaging. For example, CPT 20611 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting includes image guidance. Since the imaging is part of the procedure, you document the imaging guidance within your procedure note rather than as a separate radiology report.
This is also consistent with CMS where the payment conditions for radiology services where Medicare Claims Processing Manual Chapter 13 - Radiology Services and Other Diagnostic Procedures states: "The interpretation of a diagnostic procedure includes a written report.”
*This response is based on the best information available as of 01/22/26.
Is the ICD-10-CM code enough?
I am reaching out to ask if a provider lists the ICD-10-CM code with code description on the encounter under the Assessment and Plan if this is sufficient enough to use as their documentation and would this pass in an audit?
I do not believe this meets the ICD-10-CM guidelines and would like some clarification that I'm not querying erroneously.
Thank you in advance for your response to this matter!
Question:
I am reaching out to ask if a provider lists the ICD-10-CM code with code description on the encounter under the Assessment and Plan if this is sufficient to use as their documentation and would this pass in an audit?
I do not believe this meets the ICD-10-CM guidelines and would like some clarification that I'm not querying erroneously.
Thank you in advance for your response to this matter!
Answer:
Thank you for your query, it is a great question.
No, it is not sufficient for providers to list the code number or select a code number from a list of codes in place of a written diagnostic statement. The AHA coding clinic, specifically the 4th quarter of 2015, states that the ICD-10 codes are "statistical classifications, not replacements for a provider's written diagnosis."
*This response is based on the best information available as of 01/08/26.
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