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?
8. CPT codes 64400-64530 describe injection of anesthetic agent for diagnostic or therapeutic purposes, the codes being distinguished from one another by the named nerve and whether a single or continuous infusion by catheter is utilized. All injections into the nerve including branches described (named) by the code descriptor at a single patient encounter constitute a single unit of service(UOS). For example:
(1) If a physician injects an anesthetic agent into multiple areas around the sciatic nerve at a single patient encounter, only one UOS of CPT code 64445 (injection, anesthetic agent; sciatic nerve, single) may be reported.
(2) If a physician injects the superior medial and lateral branches and inferior medial branches of the left genicular nerve, only one UOS of CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch) may be reported regardless of the number of injections needed to block this nerve and its branches.