Overview of CPT Code 20605:'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'

Overview of CPT Code 20605:'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'

CPT Code 20605 refers to the procedure of arthrocentesis, which involves the aspiration of fluid from a major joint or bursa, or the injection of medication into the joint space. This procedure is commonly performed to relieve pain, reduce swelling, and diagnose joint disorders.

When CPT Code 20605 is Used?

This procedure is indicated in various clinical scenarios.

• Joint swelling or effusion due to arthritis or injury.
• Diagnostic evaluation of joint fluid for infection or crystals.
• Injection of corticosteroids for inflammatory conditions.
• Relief of pain in conditions like bursitis or tendinitis.

Symptoms Indicating This Procedure

Patients may report several symptoms that warrant this procedure.

• Swelling around the joint.
• Pain or tenderness in the joint area.
• Limited range of motion.
• Warmth or redness over the joint.

Causes and Risk Factors

Several factors can lead to the need for arthrocentesis.

• Osteoarthritis or rheumatoid arthritis.
• Injury or trauma to the joint.
• Gout or pseudogout.
• Infections such as septic arthritis.

Diagnostic Tests Before Procedure

Certain tests may be conducted prior to the procedure.

• X-rays to assess joint structure.
• Ultrasound to visualize joint effusion.
• Blood tests to check for inflammatory markers.
• Joint fluid analysis if previously aspirated.

Procedure Description

The procedure is performed in a clinical setting.

• The patient is positioned comfortably.
• The skin over the joint is cleaned with antiseptic.
• Local anesthesia may be administered.
• A sterile needle is inserted into the joint space.
• Fluid is aspirated if necessary, or medication is injected.
• The needle is removed, and a bandage is applied.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Inform the doctor about any medications being taken.
• Avoid blood thinners or anti-inflammatory medications as advised.
• Wear loose-fitting clothing for easy access to the joint.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure care is essential for recovery.

• Rest the joint for 24-48 hours.
• Apply ice to reduce swelling.
• Take prescribed pain medications as needed.
• Follow up with the doctor for reassessment.

Possible Complications

While generally safe, complications can occur.

• Infection at the injection site.
• Bleeding or hematoma formation.
• Nerve or blood vessel injury.
• Allergic reaction to injected medication.

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Post-Procedure Follow-Up

Monitoring after the procedure is important.

• Follow up within a week to assess joint condition.
• Monitor for signs of infection or increased pain.
• Discuss the effectiveness of the treatment.
• Plan further management if necessary.

Alternative Treatments

Other management options may be considered.

• Physical therapy to improve joint function.
• Oral anti-inflammatory medications.
• Corticosteroid pills for systemic inflammation.
• Bracing or splinting to support the joint.

Home Care Tips

Patients can take steps to aid recovery at home.

• Keep the joint elevated to reduce swelling.
• Avoid strenuous activities for a few days.
• Use over-the-counter pain relievers as needed.
• Monitor for any unusual symptoms and report them.

Patient Education & Prevention

Education is key to preventing recurrence.

• Maintain a healthy weight to reduce joint stress.
• Engage in regular low-impact exercise.
• Stay hydrated and eat a balanced diet.
• Avoid repetitive joint strain and injuries.

Billing and Coding Information

CPT Code: 20605

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $150 to $500.
• Insurance may cover the procedure if deemed medically necessary.
• Check with your provider for specific coverage details.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.
• 20604 - 'Arthrocentesis, aspiration of joint'

References and Sources

• Arthrocentesis: Indications and Techniques
• Joint Aspiration and Injection