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2025 CPT code 27369

Injection procedure for contrast knee arthrography or contrast-enhanced CT/MRI knee arthrography.

This code describes the injection procedure only. The professional component of the radiological imaging study (e.g., 73580, 73701, 73722) should be billed separately. Ensure proper coding based on the type of imaging used (X-ray, CT, MRI). Modifier 59 may be appended if using contrast injection in conjunction with a separate procedure that has NCCI edits that bundle with it.

Modifiers may be applicable to 27369 in certain circumstances.For instance, modifier 77 would be used if the injection is repeated by a different physician. Modifier 52 may be appended if reduced services are provided.

Medical necessity must be established for the use of code 27369. This typically involves documenting the patient's clinical presentation, including symptoms, physical examination findings, and previous imaging or treatment results. The rationale for using contrast-enhanced imaging should be clearly stated, such as evaluating for suspected internal derangements that are not adequately visualized with standard imaging.

The physician prepares the patient, administers local anesthesia, inserts the needle into the knee joint under fluoroscopy, injects the contrast solution, and then removes the needle.They may also perform or supervise the subsequent imaging procedure.

IMPORTANT:(Use 27369 in conjunction with 73580, 73701, 73702, 73722, 73723)(Do not report 27369 in conjunction with 20610, 20611, 29871)(For arthrocentesis of the knee or injection of any material other than contrast for subsequent arthrography, see 20610, 20611)(When fluoroscopic guided injection is performed for enhanced CT arthrography, use 27369, 77002, and 73701 or 73702)(When fluoroscopic guided injection is performed for enhanced MR arthrography, use 27369, 77002, and 73722 or 73723)(For arthroscopic lavage and drainage of the knee, use 29871)(For radiographic arthrography, radiological supervision and interpretation, use 73580)(For arthrocentesis of the knee or injection of any material other than contrast for subsequent arthrography, see 20610, 20611)(For injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography, use 27369)

In simple words: The doctor injects a special dye into your knee joint to make it easier to see the inside parts on an X-ray, CT scan, or MRI. This helps them figure out what's causing knee problems or pain.

This code represents the injection of contrast material into the knee joint for diagnostic imaging purposes, such as contrast knee arthrography, contrast-enhanced CT, or contrast-enhanced MRI knee arthrography.It is used to enhance the visualization of internal structures like cartilage, ligaments, and bones, aiding in the diagnosis of various joint conditions and unexplained pain. The procedure involves inserting a needle into the knee joint cavity under fluoroscopic guidance and injecting a contrast solution until the joint is full. This code is solely for the injection of contrast, with the subsequent imaging (X-ray, CT, or MRI) reported separately.

Example 1: A patient presents with persistent knee pain and limited range of motion following a sports injury. After a physical examination and initial X-rays are inconclusive, the physician performs a contrast-enhanced MRI arthrogram using code 27369 for the contrast injection and a separate code (73722 or 73723) for the MRI to evaluate for meniscus or ligament tears., A patient with suspected arthritis experiences worsening knee pain and swelling.The physician performs a contrast-enhanced CT arthrogram, using 27369 for the injection and 73701 or 73702 for the CT scan, to assess the joint for cartilage damage and inflammation., A patient has a history of knee instability and recurrent dislocations.The physician injects contrast into the knee joint (27369) followed by a standard knee arthrogram (73580) to evaluate the integrity of the ligaments and other supporting structures.

Documentation should include details of the injection procedure, such as the type and amount of contrast used, fluoroscopic guidance used, patient tolerance, and any complications encountered. The medical necessity for the procedure should be justified by the patient's symptoms, history, and prior diagnostic results. Documentation for the subsequent imaging study should also be included.

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