Overview of CPT Code 20973: Injection of Biologic Agent into Joint or Bursa

Overview of CPT Code 20973: Injection of Biologic Agent into Joint or Bursa

CPT Code 20973 refers to the injection of a biologic agent into a joint or bursa, primarily used to treat conditions such as arthritis or joint pain. This procedure aims to reduce inflammation and promote healing within the affected area.

When CPT Code 20973 is Used?

This code is applicable in various clinical scenarios where joint or bursa inflammation is present.

• Osteoarthritis of the knee or hip
• Rheumatoid arthritis exacerbation
• Tendinitis or bursitis
• Post-traumatic joint pain
• Chronic joint pain not responding to conservative treatments

Symptoms Indicating This Procedure

Patients may report several symptoms that indicate the need for this injection.

• Persistent joint pain or swelling
• Stiffness in the joint, especially in the morning
• Reduced range of motion
• Joint tenderness upon touch
• Symptoms not relieved by over-the-counter medications

Causes and Risk Factors

Understanding the underlying causes and risk factors can help in managing joint conditions.

• Age-related wear and tear on joints
• Previous joint injuries or trauma
• Genetic predisposition to arthritis
• Obesity, which increases joint stress
• Autoimmune disorders like rheumatoid arthritis

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the need for the injection.

• X-rays to assess joint damage
• MRI for detailed imaging of soft tissues
• Ultrasound to visualize joint effusion
• Blood tests to rule out infections or autoimmune conditions
• Joint aspiration to analyze synovial fluid

Procedure Description

The injection procedure is typically straightforward and performed in an outpatient setting.

• Patient is positioned comfortably, and the affected joint is exposed.
• Skin is cleaned with antiseptic solution to prevent infection.
• Local anesthesia may be administered to minimize discomfort.
• The biologic agent is drawn into a syringe.
• The physician carefully injects the agent into the joint or bursa using a sterile technique.
• Post-injection, the area may be massaged gently to distribute the agent.

Preparation for the Procedure

Patients should follow specific guidelines to prepare for the injection.

• Inform the physician about any allergies, especially to medications.
• Avoid blood thinners or anti-inflammatory medications for a few days prior.
• Wear loose-fitting clothing to allow easy access to the injection site.
• Arrange for transportation if sedation is used during the procedure.
• Discuss any concerns or questions with the healthcare provider.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

• Rest the joint for 24-48 hours after the injection.
• Apply ice to the injection site to reduce swelling.
• Avoid strenuous activities for a few days.
• Follow up with prescribed medications for pain management.
• Attend follow-up appointments to monitor progress.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Infection at the injection site
• Allergic reaction to the biologic agent
• Increased pain or swelling post-injection
• Joint damage if the injection is not performed correctly
• Bleeding or bruising at the injection site

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Post-Procedure Follow-Up

Monitoring after the procedure is crucial for assessing effectiveness.

• Initial follow-up within one week to evaluate response to the injection.
• Further assessments at 4-6 weeks to determine long-term effects.
• Regular check-ups if symptoms persist or worsen.
• Adjustments to treatment plan based on recovery progress.

Alternative Treatments

Several non-surgical options may be considered for joint pain management.

• Physical therapy to strengthen surrounding muscles
• Oral anti-inflammatory medications
• Corticosteroid injections for immediate relief
• Hyaluronic acid injections to lubricate joints
• Lifestyle modifications including weight loss and exercise

Home Care Tips

Patients can take simple steps at home to aid recovery.

• Keep the injection site clean and dry.
• Use ice packs to manage swelling.
• Engage in gentle range-of-motion exercises as tolerated.
• Stay hydrated and maintain a balanced diet.
• Monitor for any signs of infection or unusual symptoms.

Patient Education & Prevention

Educating patients on joint health can help prevent future issues.

• Maintain a healthy weight to reduce joint stress.
• Engage in regular low-impact exercise to strengthen joints.
• Avoid repetitive stress on joints during activities.
• Stay informed about joint health and treatment options.
• Consider supplements like glucosamine for joint support.

Billing and Coding Information

CPT Code: 20973

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 plans.

• Average cost ranges from $300 to $800 per injection.
• Insurance may cover the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's deductible and copay.
• Pre-authorization may be required by some insurance providers.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.
• 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
• 20604 - 'Arthrocentesis, aspiration of joint'
• 20600 - Aspirational Joint Injection, Aspiration, or Injection of a Major Joint or Bursa

References and Sources

• American Academy of Orthopaedic Surgeons
• National Institutes of Health
• Mayo Clinic - Joint Injections
• Cleveland Clinic - Biologic Therapies