Overview of CPT Code 20987: Injection of Biologic Agent into Joint or Bursa

CPT Code 20987 refers to the injection of a biologic agent directly into a joint or bursa to alleviate pain and inflammation associated with various musculoskeletal conditions.

When CPT Code 20987 is Used?

This procedure is indicated in several clinical scenarios.

Osteoarthritis of the knee, hip, or shoulder.
Rheumatoid arthritis exacerbations.
Tendinitis or bursitis that has not responded to conservative treatments.
Joint pain due to inflammatory conditions.

Symptoms Indicating This Procedure

Patients may report various symptoms that lead to this procedure.

Persistent joint pain that limits daily activities.
Swelling and inflammation around the joint.
Stiffness, especially in the morning or after periods of inactivity.
Reduced range of motion in the affected joint.

Causes and Risk Factors

Understanding the underlying causes can help in managing the condition.

Age-related wear and tear on joints.
Previous joint injuries or trauma.
Genetic predisposition to joint diseases.
Obesity, which increases stress on weight-bearing joints.

Diagnostic Tests Before Procedure

Several tests may be conducted to confirm the need for this injection.

X-rays to assess joint damage.
MRI to evaluate soft tissue structures.
Ultrasound to guide injection and assess joint effusion.
Blood tests to rule out systemic inflammatory diseases.

Procedure Description

The injection procedure is typically straightforward.

The patient is positioned comfortably, and the skin over the injection site is cleaned.
A local anesthetic may be applied to minimize discomfort.
Using a sterile syringe, the biologic agent is injected into the joint or bursa.
The injection site is bandaged, and the patient is monitored briefly.

Preparation for the Procedure

Patients should follow specific guidelines before 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.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

Rest the joint for 24-48 hours after the injection.
Apply ice to reduce swelling and discomfort.
Follow up with prescribed medications, if any.
Gradually resume normal activities as tolerated.

Possible Complications

While generally safe, there are potential risks involved.

Infection at the injection site.
Allergic reaction to the injected substance.
Temporary increase in pain or swelling.
Bleeding or bruising at the injection site.

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Post-Procedure Follow-Up

Monitoring after the procedure is crucial.

Schedule a follow-up appointment within 1-2 weeks.
Report any unusual symptoms, such as fever or increased pain.
Discuss the effectiveness of the injection and any further treatment options.

Alternative Treatments

There are several non-surgical options available.

Physical therapy to strengthen surrounding muscles.
Oral anti-inflammatory medications.
Corticosteroid injections for immediate relief.
Lifestyle modifications, including weight loss and exercise.

Home Care Tips

Simple tips can aid in recovery and comfort.

Keep the injection site clean and dry.
Avoid strenuous activities for a few days.
Use ice packs to manage swelling.
Stay hydrated and maintain a balanced diet.

Patient Education & Prevention

Educating patients can help prevent recurrence.

Engage in regular low-impact exercise to maintain joint health.
Maintain a healthy weight to reduce joint stress.
Consider dietary supplements like glucosamine and chondroitin.
Stay informed about joint health and seek early treatment for symptoms.

Billing and Coding Information

CPT Code: 20987

Category: Surgery

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 $300 to $800 per injection.
Many insurance plans cover the procedure, but prior authorization may be required.
Out-of-pocket costs depend on the patient's deductible and copayment.