Trigger finger injection cpt

However, CPT's section on elbow introduction or removal includes the notation, "for injection of tennis elbow, use CPT 20550" (Injection[s], single tendon sheath, or ligament, aponeurosis [e.g., plantar "fascia"]). Code 20551 might be the best choice in many cases, but check your physician's documentation to be sure you shouldn't be …

Trigger finger is thought to be caused by inflammation and subsequent narrowing of the A1 pulley of the affected digit, typically the third or fourth. The A1 pulley is most often affected, but there are some reported cases where the A2 and A3 pulleys were involved [1]. It can also occur in the thumb and is then called trigger thumb. [2] Trigger finger, right little finger M65.352 Trigger finger, left little finger M65.4 ... to the CPT/HCPCS Codes section Group 3 and ICD-10 Codes that Support Medical Necessity Group 3 for sacroiliac joint injections. CPT code 64451 has been added to the “Coding Information” section for sacroiliac joint injections. 10/01/2019 ...Description. This document addresses trigger point injections. Trigger points are small, circumscribed, hyperirritable foci in muscles, often found within a firm or taut band of skeletal muscle. Frequently affected sites include the trapezius, supraspinatus, infraspinatus, teres major, lumbar paraspinals, gluteus and pectoralis muscles.The tendons pass through the pulleys as the finger moves. The pulley at the base of the finger is called the ‘A1 pulley.’ This is the pulley that is most often involved in trigger finger.” You get trigger finger when that A1 pulley thickens or makes it tough for the flexor tendon to move through it when the finger bends.Oct 1, 2002 · The diagnosis is usually 727.05 (Other tenosynovitis of hand and wrist) or 727.03 (Trigger finger [acquired]). Florida Subscriber Answer: The diagnoses you offered indicate that the orthopedist is probably injecting the tendon sheath or ligament, which would point to 20550* ( Injection; tendon sheath, ligament, ganglion cyst ).

CPT Code 20552, General Surgical Procedures on the Musculoskeletal System, General Introduction or Removal Procedures on the Musculoskeletal System - ... Trigger point injection, or TPI, is a medical procedure that involves injecting an anesthetic or corticosteroid substance to relieve a trigger point, which is a painful area or knot in a ...No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. The code includes all injections made into the muscle.Trigger Finger (trigger thumb when involving the thumb) is the inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking, catching, and locking of the digit. Diagnosis is made by physical examination with presence of active triggering and tenderness at the A1 pulley.No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately.Inject interdigital Neuroma Destruction of Interdigital Nerve (via injection, etc.) requires at least 50% alcohol solution. (64640 does not seem to be the appropriate. CPT code. for sclerosing. injections; at least at this time) (Fanucci …Let's describe these 2 injection codes: 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) 20553 Injection(s); single or multiple trigger point(s), 3 or more muscles; Many are still so confused on how to bill for Trigger Points. Here are my Coding and Billing Tips: 1.No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. The code includes all injections made into the muscle.Quartz is a guide to the new global economy for people in business who are excited by change. We cover business, economics, markets, finance, technology, science, design, and fashi...

20605 is injection into a joint or bursa. 20552 is what you would want if it is a trigger point injection into 1 or 2 muscles. If 3 or more you would code 20553. Remember that it goes by number of mus... [ Read More ] A trigger finger is a very common and treatable problem. It can occur in both fingers and the thumbs, which have tendons that help them to bend. The flexor tendons that bend the fingers have a lining on the outside. This lining is called tenosynovium. The tendon and lining are covered by a series of thick, soft tissue called pulleys.Aug 1, 2019 ... ... finger. Tendon sheath incision (eg, for trigger finger). Excision of ganglion, wrist (dorsal or volar); recurrent. 25111. 14. CPT. Excision of ...To ask other uestions. Pease cal 1 4 000 eect Option three times. A trigger finger injection is an injection of a mixture of local anesthetic and corticosteroid into the tendon sheath of the affected finger to help relieve the symptoms of stenosing tenosynovitis, otherwise known as trigger finger. Duration Less than 30 minutes How is it performed?Morton’s neuroma ( 64455, 64632) performs in combination with CPT code 20550. It is appropriate to report 64455 and 64632 separately with the appropriate modifier. If Platelet-rich plasma injection ( 0232T) performs with 20550 CPT code, report 0232T separately with the appropriate modifier. If CPT code 20550 performs with radiologic guidance ...Corticosteroid injections. A steroid injection can be used to reduce swelling. In cases of trigger finger, liquid corticosteroids are injected into the base of the affected finger or …

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Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List each finger on separate lines on your claim and include the "F" modifier (such as F1, Left hand, second digit) to indicate the finger treated. Note: If the surgeon made two separate ...This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35010, Trigger Point Injections. Please refer to the LCD for reasonable and necessary requirements. Coding Guidance. Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if ...Learn how to bill and code trigger point injections for myofascial pain relief by physical therapists and pain management professionals. Find out the CPT codes, modifiers, units, and ICD-10-CM codes for this procedure.Change the syringe, inject 10-20 mg of steroid. Apply pressure for 5 minutes then a light dressing. Advise the patient to be cautious with use of the finger until normal sensation returns. Expect some discomfort for a day or two. Placing the needle at the base of the finger flexion crease often easier than placing it right at the A1 pulley in ...CPT Description. 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s). 20553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s). Trigger Point Injections are used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax.CPT Codes. Surgery. Surgical Procedures on the Musculoskeletal System. Surgical Procedures on the Hand and Fingers. Incision Procedures on the Hand and Fingers. 26055. 26045. 26055. 26060.

Repair of webbed fingers or toes is surgery to fix webbing of the toes, fingers, or both. The middle and ring fingers or the second and third toes are most often affected. Most oft...CPT code: Description: Price: 99203: New Patient Consultation – Low Complexity: $150: ... Trigger Finger Injection: $75: 20551: Tendon Origin/Insertion Injection: $85: 20526: Carpal Tunnel Injection: ... Trigger finger release local anesthetic: $1500: 25111: Ganglion cyst excision: $1750: 25000: DeQuervain tendonitis release: Trigger Finger Release Technique. Prep and drape in standard sterile fashion. Local anesthetic injected into skin and flexor sheath. Longitudinal incision over A1 pully between the distal transverse palmar crease and the base of the finger flexion crease. Blunt dissection under loop magnification down to A1 pulley. if you inject two different muscle groups you can bill for two injections. Physician discussed patient's trigger fingers: "we discussed the role of repeat injection to the ring finger and a first time injection for the small finger. Under aseptic technique, 0.5 mL of Kengalog 40mg/mL was injected into the subcutaneous area above the A1 pulley ...Best answers. 0. Mar 17, 2016. #1. My physician did bilateral trigger finger injections on the rt and lt 3rd digit and rt and lt 4th digits. He bill 20550-50 X1 unit. 20550 has an MUE of …2 days ago ... There are two CPT ® codes for Trigger point injections: 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) ...Aug 1, 2019 ... ... finger. Tendon sheath incision (eg, for trigger finger). Excision of ganglion, wrist (dorsal or volar); recurrent. 25111. 14. CPT. Excision of ...Finger Modifier Fact Sheet. Published on Feb 09 2016, Last Updated on May 07 2019 . ← back-to-previous-page. FB link Print Email. Jurisdictions: J8B,J5B You currently have jurisdiction ... Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS.Trigger finger causes pain, stiffness, and a sensation of locking or catching when you bend and straighten your finger. The condition is also known as “stenosing tenosynovitis.” The …Dear Editor, Stenosing tenosynovitis, or trigger finger, is an inflammation and swelling of the retinacular sheath that progressively restricts the motion of the flexor tendons [].This sheath normally forms a pulley system in each digit that functions to maximize the flexor tendon’s force and efficiency [].The first annular pulley (A1) at the …History/Background and/or General Information. Trigger point injection is one of many modalities utilized in the management of chronic pain. Myofascial trigger points are self-sustaining hyperirritative foci that may occur in any skeletal muscle in response to strain produced by acute or chronic overload.

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There are two CPT ® codes for Trigger point injections: 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553-Injection (s); single or multiple trigger point (s), 3 or more muscles. Local anesthesia is included in these services. However, imaging guidance can be billed in addition to the injection if necessary ...The codes for reporting TPs include: Injection (s); single or multiple trigger point (s); 20552 1 or 2 muscle (s) 20553 3 or more muscles. Modifiers and Units. Modifiers: Although it may seem logical to report modifiers RT, LT, or 59, the code descriptions clearly identify the codes for 1-2 muscles injected or 3 or more muscles injected, making ...No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately.Tendon sheath or Ligament: 20550 (iliolumbar ligament, trigger finger, De Quervain's tenosynovitis, plantar fascia) Tendon origin/insertion: 20551 Trigger point injection (1 or 2 muscles): 20552 Trigger point injection (3 or more muscles): 20553 Sacroiliac joint (SIJ) without fluoroscopy: 20552 (billed as a trigger point injection)Jul 2, 2020 · Medicare does not cover Prolotherapy. Its billing under the trigger point injection code is a misrepresentation of the actual service rendered. When a given site is injected, it will be considered one injection service, regardless of the number of injections administered. Utilization Guidelines Wiki - Percutaneous trigger finger release | Medical Billing and Coding Forum - AAPC. If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by ...In order to treat both of these, your physician did two procedures: Primary: Open trigger finger release (through the standard palmer incision), and Secondary: Closed manipulation of the PIP joint. Therefore, I would not consider coding each to be "unbundling." Each should be CPT coded and submitted with a Modifier to the …No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. ... Pain in right finger(s) M79.645 Pain in left finger(s ... 20605 is injection into a joint or bursa. 20552 is what you would want if it is a trigger point injection into 1 or 2 muscles. If 3 or more you would code 20553. Remember that it goes by number of mus... [ Read More ]

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Feb 3, 2011 · 6. Best answers. 0. Feb 8, 2011. #4. 20550 says "injection (s) of a single tendon sheath...) the coding tips in the coding companion state that if more than one tendon is injected in the same incounter, each injection should be reported separately. You can bill 20550 more than once during the same encounter. Just to make sure I am understanding correctly, based on the the 2010 response "Injection of painful scar tissue is reported using CPT code 64999, Unlisted procedure, nervous system" the correct code choice used to be 64999. However, the 2013 article directs us to use the appropriate injection code instead of 64999 "A "neuroma" is …There are two CPT codes for Trigger point injections, which are based on the number of muscles treated –. 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553-Injection (s); single or multiple trigger point (s), 3 or more muscles. Local anesthesia is included in these services.We would like to show you a description here but the site won’t allow us.CPT codes 20560, 20561 and 64625 have been added to a new CPT/HCPCS Codes section (Group 4). CPT code 64451 has been added to the CPT/HCPCS Codes …Swollen middle finger joints can be attributed to a condition known as trigger finger, which is a type of tendonitis that has developed in the tendons that allow the fingers to ben...Dilaudid (Hydromorphone (Injection)) received an overall rating of 8 out of 10 stars from 69 reviews. See what others have said about Dilaudid (Hydromorphone (Injection)), includin...We would like to show you a description here but the site won’t allow us.Aug 1, 2019 ... ... finger. Tendon sheath incision (eg, for trigger finger). Excision of ganglion, wrist (dorsal or volar); recurrent. 25111. 14. CPT. Excision of ...Daniel Bubnis is a nationally certified personal trainer who works independently in the Scranton, Pennsylvania area. His specialties include exercise science, health promotion, wel... ….

Feb 16, 2017 · After a short eval, the doctor decided to perform a trigger point injection on the thumb. The doctor is insisting on billing a 99214-25 along with the 20550 injection procedure. Is this correct coding, or should the office visit be considered as included in the procedure? Diagnosis: M65.312 Simple ROS, and exam only of the left thumb. Thanks in ... Trigger finger (727.03) Ganglion of tendon sheath (727.42) Contracture of joint, hand/fingers (718.44) Loc prim osteoarthritis, hand (715.14) Pain in joint, hand (719.44) CPT Codes Injection, tendon sheath, ligament, trigger points or ganglion cyst (20550) Aspiration or injection ganglion cyst (20612)20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) 20553 Injection(s); single or multiple trigger point(s), 3 or more muscles Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72.2.Conclusions: Trigger finger injections with triamcinolone demonstrate a higher rate of additional injections when compared with dexamethasone and methylprednisolone. Patients who underwent methylprednisolone injection had surgical release performed earlier and more frequently than the other 2 groups. The choice of corticosteroid significantly ...Trigger point injection- an invasive procedure where medication is injected directly into a trigger point. 5 . Background. ... Enter the CPT/HCPCS code in the MCD Search and select your state from the drop down. (You may have to accept the AMA License Agreement.) Look for a Billing and Coding Article in the results and open it.You'll need to use the correct modifier for each finger. 20551-F7 (right hand, middle finger) 20551-F3 (left hand, ring finger)There are two CPT codes for Trigger point injections, which are based on the number of muscles treated –. 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553-Injection (s); single or multiple trigger point (s), 3 or more muscles. Local anesthesia is included in these services.CPT Codes. Injection, therapeutic; carpal tunnel (20526) Endoscopic carpal tunnel release (29848) Neuroplasty and/or transposition; median nerve at carpal tunnel (64721) Neuroplasty, major peripheral nerve, arm or leg; other than specified (64708) Tenotomy, open flexor or extensor tendon, forearm and/or wrist, single, each tendon (25290)Injuries from electrical outlets can injure, maim, or even kill you. Find out exactly what could happen if you stick your finger in an outlet. Advertisement Many people, parents in...Learn how to bill and code trigger point injections for myofascial pain relief by physical therapists and pain management professionals. Find out the CPT codes, modifiers, units, and ICD-10-CM codes for this procedure. Trigger finger injection cpt, Injection of the flexor tendon in the hand is most commonly performed for the treatment of stenosing tenosynovitis. Stenosing tenosynovitis, also known as trigger finger, involves a size mismatch between a thickened or stenotic first annular (A1) pulley in the hand and the flexor tendon trying to glide through the pulley., Trigger finger is a common condition usually curable by a safe, simple corticosteroid injection. Trigger finger results from a stenotic A1 pulley that has lost its gliding surface producing friction and nodular change in the tendon. This results in pain and tenderness to palpation of the A1 pulley, progressing to catching and then locking., No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. The code includes all injections made into the muscle., The CPT codes for injections into trigger points (which are based on the number of muscles treated) include –. 20552 – Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553 – Injection (s); single or multiple trigger point (s), 3 or more muscles. However, only a single code from 20552 or 20553 should be reported on ..., Mar 13, 2021 ... FLEXOR TENDONITIS / TRIGGER FINGER INJECTION - Simulation Series. RheumTutor•624 ... FLEXOR TENDONITIS / TRIGGER FINGER INJECTION - In-Vivo Series., Oct 1, 2015 · Coverage Guidance. This policy addresses the injection of chemical substances, such as local anesthetics, steroids, sclerosing agents and/or neurolytic agents into ganglion cysts, tendon sheaths, tendon origins/insertions, ligaments or near nerves of the feet (e.g., Morton's neuroma) to affect therapy for a pathological condition. , control injections performed today are known as trigger point injections, trigger point therapy, or pressure point therapy. In order to clarify and assist in accurate coding of these injections, codes 20552 and 20553 were revised for CPT 2003. Before we discuss the revisions for 2003, we will explain a, Do you have to apologize if you have COVID-19 and unknowingly exposed someone else? In early January, I contracted the virus that causes COVID-19. My symptoms were mild, but my men..., Trigger Finger (trigger thumb when involving the thumb) is the inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking, catching, …, © 1995-2024 by the American Academy of Orthopaedic Surgeons. "All Rights Reserved." This website and its contents may not be reproduced in whole or in part without ..., Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List each finger on separate lines on your claim and include the "F" modifier (such as F1, Left hand, second digit) to indicate the finger treated. Note: If the surgeon made two separate ..., Injection of the flexor tendon in the hand is most commonly performed for the treatment of stenosing tenosynovitis. Stenosing tenosynovitis, also known as trigger finger, involves a size mismatch between a thickened or stenotic first annular (A1) pulley in the hand and the flexor tendon trying to glide through the pulley., Trigger Finger Release Technique. Prep and drape in standard sterile fashion. Local anesthetic injected into skin and flexor sheath. Longitudinal incision over A1 pully between the distal transverse palmar crease and the base of the finger flexion crease. Blunt dissection under loop magnification down to A1 pulley., Coding- Trigger Finger 11 •Injection- 20550- Injection(s); single tendon sheath, or ligament, aponeurosis •Trigger Finger Release- 26055- tendon sheath incision (eg, for trigger finger) •M65.3X- Trigger Finger •M65.331-Trigger Finger, right middle finger Dupuytren’sDisease 12 Nodule Cord of fibrous tissue , A study released today finds that big earthquakes around the world have triggered separate quakes in the US where wastewater resulting from natural gas production is injected under..., The number of injections in the same finger averaged 1.25 injections/finger (range, one to four injections/finger) for our entire study group. Recurrence after the first, second, third, and fourth injections was 34.0, 47.9, 26.1, and 75.0 %, respectively, the cumulative recurrence was 20.3 %., Decompression fingers and/or hand, injection injury eg, grease gun, etc) (26035) Decompressive fasciotomy, hand (excludes 26035) (26037) Fasciotomy, palmar, for Dupuytrens contracture; closed (subcutaneous) (26040) Fasciotomy, palmar, for Dupuytrens contracture; open, partial (26045) Tendon sheath incision eg, for trigger finger) (26055), Each injection of Kenalog consists of a 10 mg dosage, for a total of 50 mg. To report this treatment, you must code for both the procedure, using a CPT® code, and for the drug supply of Kenalog, using a HCPCS code. First, let’s consider our CPT® code. 20552 Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s), Change the syringe, inject 10-20 mg of steroid. Apply pressure for 5 minutes then a light dressing. Advise the patient to be cautious with use of the finger until normal sensation returns. Expect some discomfort for a day or two. Placing the needle at the base of the finger flexion crease often easier than placing it right at the A1 pulley in ..., The Triggers - There are a number of technologies that detect when a car has moved past a particular point in the road. Find out how. Advertisement There are a number of trigger te..., Sep 15, 2005 · M65.30 Trigger finger, unspecified finger M65.311 – M65.359 Trigger finger M65.4 Radial styloid tenosynovitis [de Quervain] M65.80 Other synovitis and tenosynovitis, unspecified site M65.811 – M65.9 Other synovitis and tenosynovitis M65.841 – M65.849 Other synovitis and tenosynovitis, hand , Aspiration and Injection CPT Codes. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; carpal tunnel (20526) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) Arthrocentesis ..., Best answers. 0. Mar 25, 2008. #2. If the release was done through an incision try 26055; "The physician makes an incision in a tendon sheath to release tension in the tendon. (For example, this procedure would be performed to relieve trigger finger .) The physician incises the skin overlying the tendon and dissects to the tendon sheath The ..., Aspiration and Injection CPT Codes. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; carpal tunnel (20526) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) Arthrocentesis ..., Trigger Finger Release. Comments. TECHNIQUE STEPS 0 % 0. 0 Preoperative Patient Care A. Intermediate Evaluation and Management. 1. Obtain focused history and performs focused exam . check range of motion check radial and ulnar pulses ..., Trigger finger is a commonly occurring hand condition that presents with symptoms of pain, clicking, locking, and catching of the finger. A common non-operative management option is corticosteroid injection. The purpose of this study was to evaluate the short-term patient response to corticosteroid injections for trigger finger. Methods, Article Guidance. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33912, Injection of Trigger Points. Please refer to the LCD for reasonable and necessary requirements. Coding Guidelines., Therefore when the internist injects three different muscles you can only report one code 20553. Before CPT introduced 20552-20553 in 2002 internal medicine coders could use modifier -59 to report 20550 (Injection; tendon sheath ligament or ganglion cyst) multiple times for trigger point injections in different sites. Created Date., TRIGGER FINGER. Trigger finger, or stenosing tenosynovitis, occurs when the flexor tendons cannot pass through the A-1 pulley smoothly. Whether the pulley thickens, the tenosynovium thickens and/or the tendons deform and develop a "nodule," the result is the same: loss of smooth active flexion and extension in the digit. , Find the CPT and ICD codes for trigger finger injection, a procedure to release the tendon sheath around the finger. The web page lists the most common coding combinations, …, Get Dx Just Right on Trigger Finger Injection. Question: Encounter notes indicate that the provider saw a patient in the office for pain in her finger. After an evaluation and management (E/M) service that included low medical decision making (MDM) and lasted 27 minutes, the provider diagnosed trigger finger. They then performed a tendon sheath ..., Sep 22, 2021 · The patient was also treated for other problems during the office visit. All was paid except the 2nd injection. This is how it was billed. 99213/25. 20550/RT-F7. 20550/59-LT This was not paid. j1040*2. We resubmitted the unpaid injection multiple times, as follows and all were denied: 20550/59-f2. , Procedure code and description. 20550 Injection (s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia’’) 20551 Injection (s); single tendon origin/insertion. 20600 – Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance – average fee payment – $50 – $60.