Sometimes Podiatrists have to provide specific injections in the big toe joint or the 1st MTP joint as it is commonly referred. Whether it is for gout or capsulitis there are multiple methods to accomplish this. Now the key to billing and coding this is such that you want to bill 76942, which is defined as the ultrasound guided needle and placement.
Following that you want to bill 20604, which is defined as arthrocentesis and aspiration of the small joints, i.e the Big Toe joint.
Now to be clear if you have decided to bill this it is extremely important that your documentation of the ultrasound examination is thorough. In other words don’t perform the exam on some cheap 1950’s ultrasound machine. Ultrasound machines today are inexpensive and available on Amazon here is a simple one you can use: