Overview of CPT Code 20690:'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
CPT Code 20690 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 20690 is Used?
This procedure is indicated in various clinical scenarios.
- Joint swelling due to arthritis or bursitis.
- Diagnostic evaluation of joint effusion.
- Injection of corticosteroids for inflammatory conditions.
- Relief of pain in conditions like gout or pseudogout.
- Management of joint disorders such as synovitis.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant this procedure.
- Swelling around the joint.
- Pain or tenderness in the joint.
- Limited range of motion.
- Warmth or redness over the joint.
- Joint stiffness, especially in the morning.
Causes and Risk Factors
Several factors can lead to the need for arthrocentesis.
- Osteoarthritis or rheumatoid arthritis.
- Injury or trauma to the joint.
- Infection in the joint (septic arthritis).
- Gout or pseudogout.
- Previous joint surgeries or conditions.
Diagnostic Tests Before Procedure
Certain tests may be conducted to guide the procedure.
- X-rays to assess joint structure.
- Ultrasound to visualize joint effusion.
- MRI for detailed imaging of soft tissues.
- Blood tests to check for inflammatory markers.
- Joint fluid analysis if aspiration is performed.
Procedure Description
The procedure is performed in a clinical setting.
- Patient is positioned comfortably.
- 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.
- 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.
- Arrive at the appointment with a list of symptoms and questions.
- Consider bringing someone to assist post-procedure 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.
- Avoid strenuous activities for a few days.
- 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.
- Persistent pain or swelling.
Secure, compliant, and built for trust
HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.
Learn more
Post-Procedure Follow-Up
Monitoring after the procedure is important.
- Schedule a follow-up appointment within a week.
- Monitor for signs of infection or increased pain.
- Discuss the effectiveness of the procedure.
- Adjust treatment plans based on recovery.
- Regular check-ups for chronic conditions.
Alternative Treatments
Other management options may be considered.
- Physical therapy to improve joint function.
- Oral anti-inflammatory medications.
- Corticosteroid pills for systemic inflammation.
- Topical analgesics for localized pain relief.
- Lifestyle modifications including weight management.
Home Care Tips
Patients can take steps to aid recovery at home.
- Keep the joint elevated to reduce swelling.
- Use ice packs for 15-20 minutes several times a day.
- Follow a gentle exercise routine as advised.
- Stay hydrated and maintain a balanced diet.
- Monitor symptoms and report any concerns to the doctor.
Patient Education & Prevention
Education is key to preventing recurrence.
- Understand the importance of joint health.
- Engage in regular low-impact exercise.
- Maintain a healthy weight to reduce joint stress.
- Avoid repetitive joint strain activities.
- Stay informed about joint conditions and treatments.
Billing and Coding Information
CPT Code: 20690
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $150 to $500.
- Insurance may cover the procedure if deemed medically necessary.
- Check with your provider for specific coverage details.
- Out-of-pocket costs may apply depending on the plan.
- Additional costs may arise for follow-up visits or imaging.
Related CPT Codes
- 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
- 20610 - 'Arthrocentesis, aspiration of joint'
- 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.
- 20680 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa
- 20690 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
References and Sources
Frequently Asked Questions (FAQs)
What is arthrocentesis?
Arthrocentesis is a procedure to remove fluid from a joint or inject medication.
Is the procedure painful?
Most patients experience minimal discomfort, especially with local anesthesia.
How long does recovery take?
Recovery is usually quick, with most patients resuming normal activities within a few days.
What should I do if I notice swelling after the procedure?
Contact your healthcare provider if swelling persists or worsens.
Can I drive after the procedure?
You may drive unless sedation was used; check with your doctor.
