Overview of CPT Code 20696: Arthrocentesis, aspiration, and/or injection into a major joint or bursa

Overview of CPT Code 20696: Arthrocentesis, aspiration, and/or injection into a major joint or bursa

CPT Code 20696 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 20696 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 to guide 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.

• 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 present, 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 support person if needed.

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.

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 with the doctor.

Alternative Treatments

Other management options may be considered.

• Physical therapy to improve joint function.
• Oral anti-inflammatory medications.
• Corticosteroid pills for systemic inflammation.
• Lifestyle modifications such as weight management.

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 directed.
• Stay hydrated and maintain a balanced diet.

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.
• Seek early treatment for joint pain or swelling.

Billing and Coding Information

CPT Code: 20696

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 insurance provider for specific coverage details.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
• 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.
• 20612 - 'Arthrocentesis, aspiration, and/or injection into major joint or bursa'
• 20680 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa

References and Sources

• Arthrocentesis: Indications and Techniques
• Joint Aspiration and Injection