Knee joint injection cpt

20611—Arthrocentesis, aspiration and/or injection, large joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting. (do not report 20610, 20611 in conjunction with 27370, 76942) J1040 is for injection, methylprednisolone acetate 80 mg. The lidocaine is considered …

If the provider performs joint aspiration/injection with US guidance, select 20604, 20606 or 20611 (depending on the joint targeted). If the provider aspirates/injects the joint/bursa without guidance of any kind, select from among 20600, 20605 and 20610. CPT® allows you to separately report fluoroscopic, CT or MRI guidance for needle ... Proximal Interphalangeal Joint Injection; Subacromial Bursa Injection; Trigger Finger Injection; Lower Extremity. First Metatarsophalangeal Joint Injection; Pes Anserine Bursa Injection; Hip Joint Injection – Lateral Approach; Hip Joint Injection – Anterior Approach; Intraarticular Knee Joint Injection; Prepatellar Bursa Aspiration and ...CPT codes not covered for indications listed in the CPB: 0232T: ... (2013) undertook a systematic review to determine the accuracy of intra-articular knee injection (IAKI) and whether this varied by site, use of image-guidance, and experience of injectors, and whether accuracy of injection, site, or use of image-guidance influenced outcomes ...The next step is the Injection Procedure which is probably most often the knee joint for arthritis, maybe other joints/sites. This would usually be 20610, Major Joint. Since this is a "Staged Procedure," I would add Modifier 58 to the injection code. If injected into another site (tendon, ligament, soft tissue, etc.) then another code would apply.Hyaluronic acid injections in Medicare knee osteoarthritis patients are associated with longer time to knee arthroplasty. The Journal of Arthroplasty. 2016;31:1667-1673. Jevsevar D, Donnelly P, Brown GA, Cummins DS. Viscosupplementation for osteoarthritis of the knee: A systematic review of the evidence.CPT® allows you to separately report fluoroscopic, CT, or MRI guidance for needle placement during joint/bursa aspiration/injection, when performed. Claim the “without ultrasonic guidance” code for the aspiration/injection, plus 77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), 77012 ...

The Pes Anserinus is actually a bursa and is located on the medial side of lower leg distal to the knee joint. It is considered an accessory structure to the knee joint and the 20610 would apply. The CPT description indicates "major joint or bursa". That's the code I use--hope that helps.Sep 19, 2015 · Proximal Interphalangeal Joint Injection; Subacromial Bursa Injection; Trigger Finger Injection; Lower Extremity. First Metatarsophalangeal Joint Injection; Pes Anserine Bursa Injection; Hip Joint Injection – Lateral Approach; Hip Joint Injection – Anterior Approach; Intraarticular Knee Joint Injection; Prepatellar Bursa Aspiration and ... An anatomically accurate adult knee model for injection and aspiration of synovial fluid from the knee joint, from both the lateral and medial aspects, ...Sparks, NV. Best answers. 0. May 1, 2017. #1. My physician did a Supartz knee injection and a Baker's cyst drainage during the same session (same knee). On the Supartz injection, he identified the superior and lateral corner of the knee under USG and then advanced the needle into the knee joint. For the Baker's cyst was located in the …If the provider performs joint aspiration/injection with US guidance, select 20604, 20606 or 20611 (depending on the joint targeted). If the provider aspirates/injects the joint/bursa without guidance of any kind, select from among 20600, 20605 and 20610. CPT® allows you to separately report fluoroscopic, CT or MRI guidance for needle ... Dec 13, 2007. #1. One of my doctors does joint injections of the large joints (20610). He administers J3301, J2001, J0670 (kenallogg, marcaine, and lidocaine) in a premixed solution. The Medicare appeals line told our office that we should be adding a 59 modifier to the J2001 (lidocaine) for it to be paid. However it is all part of the same ...Coding and Reimbursement Issues for Platelet-Rich Plasma Margie Scalley Vaught, CPC, CPC-H, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR,* and Brian J. Cole, MD, MBA† As of July 1, 2010, there were new changes in the reporting of platelet-rich plasma (PRP) injections. This review summarizes what this service is and the proper coding required …The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a bilateral procedure.

20600 Inject/Aspirate “Small” Joint 20605 Inject/Aspirate “Intermediate” Joint (midfoot) 20612 Inject/Aspirate Ganglion Cyst(s) 64450 Inject Peripheral Nerve (non-interdigital) 64455 Inject interdigital Neuroma 64999 Destruction of Interdigital Nerve (via injection, etc.) requires at least 50% alcohol solution Temporary side effects of cortisone knee injections include localized pain, elevated blood sugar, facial redness and whitening of skin around the injection site, explains About.com. Serious complications include infection, nerve damage and ...Mar 23, 2009 · 20551-injection; single tendon origin/insertion 20610-arthrocentesis, aspiration and/or injection; major joint or bursa. It looks like this could go either way. I think I would use the 20551 for the injection unless it states as in the last sentence that the knee joint itself is injected. But, I would confirm this with dictation and/or ask the Dr. Spondylarthritis - A group of inflammatory arthritis affecting the axial skeleton including the sacroiliac joint and spine with or without peripheral joints and is often associated with HLA- B27. 17. Subacute Pain – The temporal definition of pain occurring during the six (6) to twelve-week (12) time period.

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Procedure code 20611 is one of the new code changes in the 2015 Procedure code ™ and there are a total of six changes to this group of codes (20600 -20611). 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., Temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound ...The last injection (in a prior course) was given at least six (6) months ago. Repeat injections for shoulder arthritis are limited to a single repeat course. Coding information: If an aspiration and an injection procedure are performed at the same session, bill only one unit for CPT code 20610 or 20611.Answer: Trigger point injections (20552, one or two muscles and 20553, three or more muscles) are bundled with joint injection (20600-20611) when performed at the same anatomical site, for example a trigger point in the shoulder with a shoulder joint injection. If the joint injection and trigger point are at different anatomical sites, as in ...of an office visit was for the patient to receive an injection, payment may be made only for the injection service (if it is covered). Conversely, injection services included in the Medicare Physician Fee Schedule (MPFS) are not paid for separately if the physician is paid for any other physician fee schedule service furnished at the same time.A wide range of LIA techniques for total knee arthroplasty have been described in recent literature. In earlier studies, the volume of the mixture of local anesthetics and adjuvants used was lower than 50 mL. In the study of Kerr and Kohan, a mixture of ropivacaine (2 mg/mL, maximum 300 mg), ketorolac (30 mg), and epinephrine (10 μg/mL) was ...are required for the performance of paravertebral facet joint injections described by codes 64490-64495. If imaging is not used, report 20552-20553. If ultrasound guidance is used, report 0213T-0218T) (For bilateral paravertebral facet injection procedures, report 64490, 64493 with modifier 50. Report add-on codes 64491, 64492, 64494, 64495 twice,

Knee joint aspiration and injection are performed to establish a diagnosis, relieve discomfort, drain off infected fluid, or instill medication. Because prompt treatment of a joint infection can ...CPT: 20610: Arthrocentesis, major joint or bursa * Include modifiers -RT, -LT or 50 (bilateral) ... or in severely inflamed knee joints have not been established. Use caution when injecting SYNVISC or SYNVISC-ONE in patients allergic to avian proteins, feathers, or egg products; who have evidence of lymphatic or venous stasis in the leg to be ...Intra-articular knee injections as well as other peripheral joint injections have been successfully utilized for several decades [1]. Knee injections may be ...It is frequently used to treat pain in a variety of clinical settings. Although there are oral formulations, it is more commonly used as an intravenous or intramuscular injection, or as ophthalmologic drops. A growing …20610 - Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) No A9513 - Lutetium Lu 177, dotatate, therapeutic, 1 mCi Yes A9579 - Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml No C9036 - Injection, patisiran, 0.1 mg YesCPT . 01937. Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic. 01938. Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral. 01939The most common arthroscopic surgery is arthroscopic knee surgery, which is minimally invasive. It utilizes an arthroscope (a narrow tube with a tiny camera), allowing the surgeon to examine and treat damage in the joint’s interior.Sparks, NV. Best answers. 0. May 1, 2017. #1. My physician did a Supartz knee injection and a Baker's cyst drainage during the same session (same knee). On the Supartz injection, he identified the superior and lateral corner of the knee under USG and then advanced the needle into the knee joint. For the Baker's cyst was located in the …Joint Injection, is an orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured and painful joints and connective tissue. Prolotherapy is injection of any substance (i.e., dextrose, saline, sarapin and procaine or

Oct 3, 2018 · For each injection given, the procedure code which accurately reflects the products used and 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance), may be billed when viscosupplementation of the knee is performed.

This paper demonstrates that the traditional approaches to aspiration or injection of the knee are easily performed and are generally safe, but also highlights the …CPT code Medicare reimbursement* Estimated physician time (minutes) Initial cost of equipment ... Joint injection, large joint (e.g., shoulder, knee, hip) 20610*** $67: 5: Supplies only: $804:The last injection (in a prior course) was given at least six (6) months ago. Repeat injections for shoulder arthritis are limited to a single repeat course. Coding information: If an aspiration and an injection procedure are performed at the same session, bill only one unit for CPT code 20610 or 20611.We can use the 50 along with procedure CPT codes 20600, 20604, 20605, 20606, 20610, and 20611 to code bilateral joint aspiration on both sides. However, when performing joint aspiration on two different small or major joints, we must use a 59 modifier with any of the CPT. For example, if arthrocentesis is performed on the shoulder and hip joint ...Indicate which knee was injected by using the RT (right) or LT (left) modifier (FAO-10 electronically) on the injection procedure (CPT 20610). Place the CPT code 20610 in item 24D. If the drug was administered bilaterally, a -50 modifier should be used with 20610.Coding and Reimbursement Issues for Platelet-Rich Plasma Margie Scalley Vaught, CPC, CPC-H, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR,* and Brian J. Cole, MD, MBA† As of July 1, 2010, there were new changes in the reporting of platelet-rich plasma (PRP) injections. This review summarizes what this service is and the proper coding required of PRP ...Indicate which knee was injected by using the RT (right) or LT (left) modifier (FAO-10 electronically) on the injection procedure (CPT 20610). Place the CPT code 20610 in item 24D. If the drug was administered bilaterally, a -50 modifier should be used with 20610.

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Glenohumeral joint injection by targeting the rotator interval. a The rotator interval (*) is limited superiorly by the supraspinatus tendon (SS), anteriorly by the subscapularis tendon (sSc) and contains the long head of the biceps tendon (LB).b The target is the upper medial quadrant of the humeral head.c and d Insertion of the needle …If an aspiration and an injection procedure are performed at the same session, bill only 1 unit for CPT® code 20610 or 20611. When additional substances simultaneously administer (e.g., cortisone, anesthetics) with viscosupplementation, only 1 injection service is allowed per knee. The appropriate site modifier (RT or LT) must be appended to ...Take the challenge. CPT: 20611-RT, J1040, 89060 ICD-10: M17.11 Coding Rationale Keep in mind, no evaluation and management services are billed because there wasn’t a separate and/or significant reason, other than the knee injection, addressed during the visit. Note: Although the injection was performed via ultrasound guidance, CPT code …Oct 1, 2019 · Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot. 11 thg 2, 2015 ... For example, in 2014, CPT code 20600 only referenced an arthrocentesis, aspiration and/or injection; small joint or bursa. For 2015, code ...which knee was injected by using the RT (right) or LT (left) modifier (FAO-10 electronically) on the injection procedure (CPT 20610). Place the CPT code 20610 in item 24D. If the drug was administered bilaterally, a -50 modifier should be used with 20610. 4. When this drug is administered in the hospital (inpatient or outpatient) setting, the drug/visco …Applies To: CPT© Procedure Codes 20610 Arthrocentesis, aspiration and/or injections; major joint or bursa 76942 Ultrasonic guidance for needle placement, imaging supervision and interpretation, ... - Failure of the initial attempt of a knee joint injection - Size of the knee due to morbid obesity (BMI ≥ 40) or other disease process - Aspiration of a Baker’s …One fingerbreadth above Patella edge. One fingerbreadth lateral to Patella edge. Needle Insertion. Angle needle 45 degrees distally. Angle needle 45 degrees posteriorly (into knee) Medial Suprapatellar Approach. Knee flexed 60-90 degrees. Insert needle medial to Patella r tendon. Stay parallel to tibial plateau. ….

Use "EJ" modifier on drug codes to indicate subsequent injections of a series. Do not use this modifier for the first injection of each series. A series is defined as the set of injections for each joint and each treatment. Injection of the left knee or shoulder is a separate series from injection of the right knee or shoulder.Use code 20610 for an Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa). Use this code if an SI Joint Injection is done without any imaging (instead of 27096 or G0260). 3. Joint Manipulations CPT guidelines are that if a surgical arthroscopy is performed on the same joint when a Aspiration and Injection CPT Codes. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) Use "EJ" modifier on drug codes to indicate subsequent injections of a series. Do not use this modifier for the first injection of each series. A series is defined as the set of injections for each joint and each treatment. Injection of the left knee or shoulder is a separate series from injection of the right knee or shoulder.The how and why of knee injections—what a doctor will administer and where—depends on the cause of the discomfort, says Anuj Malhotra, MD, Director of the Division of Pain Management at HSS and a specialist in pain medicine.Inflammation in the joint, whether the result of an acute injury or, more often, the bone-on-bone contact caused by arthritis, is the most common culprit.Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot.INTRAARTICULAR knee injections with local anesthetic can be performed preoperatively for minor arthroscopic knee surgery. The benefit and safety of these injections have been confirmed by multiple studies. 1,2 The suprapatellar bursa is the most common site to perform an intraarticular knee injection. 3 We demonstrate that ultrasound guided …Knee joint aspiration and injection are performed to aid in diagnosis and treatment of knee joint diseases. The knee joint is the most common and the easiest joint for the physician...Procedure code 20611 is one of the new code changes in the 2015 Procedure code ™ and there are a total of six changes to this group of codes (20600 -20611). 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., Temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound ... Knee joint injection cpt, OBJECTIVE. The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. MATERIALS AND METHODS. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period …, CPT CODE J3301 – Kenalog-40 Injection. Kenalog-40 Injection (triamcinolone acetonide injectable suspension, USP) is a synthetic glucocorticoid corticosteroid with anti-inflammatory action. ... For treatment of joints, the usual intra-articular injection technique should be followed. If an excessive amount of synovial fluid is present in the ..., For CPT® 2015, the AMA revised previous joint (or bursa) aspiration/injection codes to specify "without ultrasonic guidance," while adding codes to describe the same procedures with ultrasonic (US) guidance: 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance, Of the patient encounters in which an MSK injection occurred (n=766), the most common site was the knee (47.00%) followed by the shoulder (25.20%). The most common injection was the landmark-guided large joint injection (64.23%)., PAGE 3 OF 3 ICD-10-CM Diagnosis Code Options – Facet Joints† Disclaimer: Information provided is derived from a variety of public sources as of January 1, 2023 and is intended for general purposes only. It does not constitute reimbursement or legal advice. It is not intended to increase or maximize reimbursement by payer., The knee joint relies on a variety of ligaments, tendons, and soft tissue structures ... any meniscal shaving) or CPT® code 29881, Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)if performed in a separate compartment. Example: 29888 – ACL Repair G0289 - Arthroscopy, knee, surgical, for removal of loose …, Use "EJ" modifier on drug codes to indicate subsequent injections of a series. Do not use this modifier for the first injection of each series. A series is defined as the set of injections for each joint and each treatment. Injection of the left knee or shoulder is a separate series from injection of the right knee or shoulder., CMS proposed CPT code 76942 (Ultrasonic guidance for needle placement (for example, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) as a potentially misvalued code because of the high frequency with which it is billed with CPT code 20610 Arthrocentesis aspiration and/or injection; major joint or ..., Answer: CPT instructs to report CPT code 20552 for unilateral or bilateral SI joint injections if CT or Fluoroscopic imaging is not used. CPT code 76942, for the ultrasound guidance, may be reported if the documentation requirements are met. source: CPT Assistant April 2022. *This response is based on the best information available as of 11/03/22., Am Fam Physician. 2003;67 (10):2147-2152. Joint injection of the hip and knee regions is a useful diagnostic and therapeutic tool for the family physician. In this article, the injection procedure ..., For each injection given, the procedure code which accurately reflects the products used and 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance), may be billed when viscosupplementation of the knee is performed., 20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) Trigger Point Injections (CPT codes 20552 and 20553) * Medicare does not have a National Coverage Determination (NCD) for trigger point injections. * Local Coverage Determinations (LCDs) which address these injections …, are required for the performance of paravertebral facet joint injections described by codes 64490-64495. If imaging is not used, report 20552-20553. If ultrasound guidance is used, report 0213T-0218T) (For bilateral paravertebral facet injection procedures, report 64490, 64493 with modifier 50. Report add-on codes 64491, 64492, 64494, 64495 twice,, Applies To: CPT© Procedure Codes 20610 Arthrocentesis, aspiration and/or injections; major joint or bursa 76942 Ultrasonic guidance for needle placement, imaging supervision and interpretation, ... - Failure of the initial attempt of a knee joint injection - Size of the knee due to morbid obesity (BMI ≥ 40) or other disease process - Aspiration of a Baker’s …, Jul 13, 2022 · These injections are crossing over to primary: OA (eg. M17.0) and secondary: Knee Joint Pain (M25.561, M25.562) CPT Codes: 20610 (unilateral), add 77002 if you perform under Fluoroscopy 20611 (unilateral) - if you perform under ultrasound If the injecti , *These CPT codes represent the most commonly ordered CT exams. For any coding inquiry not listed please call us at 800-841-4236 ext. 59109. 2020 MRI CPT CODES* TMJ/Orbits/Face/Neck TMJ(s) 70336 w 70542 wo 70540 w/wo 70543 Head w 70545 ... Arthrogram shoulder injection/joint 23350 Arthrogram knee injection/joint 27369 …, Answer: CPT instructs to report CPT code 20552 for unilateral or bilateral SI joint injections if CT or Fluoroscopic imaging is not used. CPT code 76942, for the ultrasound guidance, may be reported if the documentation requirements are met. source: CPT Assistant April 2022. *This response is based on the best information available as of 11/03/22., ICD-10 code: M70.5 “other bursitis of knee” CPT code: 20610 “Arthrocentesis, aspiration and/or injection; major joint or bursa ..., Billing the injection procedure: The CPT® code (procedure code) 20610 or 20611 (with ultrasound guidance) may be billed for the intra-articular injection in addition to the drug. If an aspiration and an injection procedure are performed at the same session, bill only 1 unit for CPT® code 20610 or 20611. When additional substances ..., HCPCS Code Billing Unit Drug Name (s)Dosing frequency per series (per knee) *Dose (per knee) *Units per dose (per knee) The following HCPCS codes are per …, Fluoroscopic Guidance for Knee Injections. Maricar, et al. (2013) undertook a systematic review to determine the accuracy of intra-articular knee injection (IAKI) and whether this varied by site, use of image-guidance, and experience of injectors, and whether accuracy of injection, site, or use of image-guidance influenced outcomes following IAKIs. , Aspiration and Injection CPT Codes. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) , CPT codes not covered for indications listed in the CPB: 0232T: ... (2013) undertook a systematic review to determine the accuracy of intra-articular knee injection (IAKI) and whether this varied by site, use of image-guidance, and experience of injectors, and whether accuracy of injection, site, or use of image-guidance influenced outcomes ..., Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot. , Cardone DA, Tallia AF. Joint and soft tissue injection. Am Fam Physician. 2002;66(2):283-288. Peterson C, Hodler J. Adverse events from diagnostic and therapeutic joint injections: a literature ..., Applies To: CPT© Procedure Codes 20610 Arthrocentesis, aspiration and/or injections; major joint or bursa 76942 Ultrasonic guidance for needle placement, imaging supervision and interpretation, ... - Failure of the initial attempt of a knee joint injection - Size of the knee due to morbid obesity (BMI ≥ 40) or other disease process - Aspiration of a Baker’s …, three injections. Synvisc-One™- (48mg/6ml) - single dose injection . 3. The aspiration and/or injection procedure code may be billed in addition to the drug. Indicate which knee was injected by using the RT (right) or LT (left) modifier (FAO-10 electronically) on the injection procedure (CPT 20610). Place the CPT code 20610 in item 24D. , “-50” (bilateral procedure) to be documented after CPT code 20610. In addition payers may require EJ modifier, usually following the first injection, to indicate subsequent injections in a series of injections. A series of injections for each joint and each treatment, left knee is a separate series from the right knee. 20611 Arthrocentesis ..., See full list on aapc.com , If the provider performs joint aspiration/injection with the aid of US guidance, code application is straightforward: Select 20604, 20606, or 20611, depending on the joint targeted. Example: Using US guidance for precise needle placement, the provider injects bupivacaine into the knee joint for pain management. Because the knee is defined as a ..., Rheumatology Coding Corner Answer: Coding for a Knee Injection. From the College | January 25, 2017. CPT: 20611-LT, J7325 X 1. ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg. ICD-10: M17.12—Unilateral primary osteoarthritis, left knee., CPT code: 20610 “Arthrocentesis, aspiration and/or injection; major joint or bursa” Materials Needed. Pen – clicking type; Gloves – non-sterile; Alcohol swabs (or providone-iodine) Band-aid; 25-gauge 1.5″ needle (depending on body habitus) and 3-5ml syringe Medial Approach. Advance needle at about 15-20 degrees from midline. Injectate, The Pes Anserinus is actually a bursa and is located on the medial side of lower leg distal to the knee joint. It is considered an accessory structure to the knee joint and the 20610 would apply. The CPT description indicates "major joint or bursa". That's the code I use--hope that helps.