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[7] Early detection and treatment prevent irreversible complications

Three things arent included and must be billed separately: the medication injected (billed via HCPCS J-codes), ultrasound guidance (if used, switch to CPT 20611 with permanent recording and reporting), and a separately identifiable evaluation and management service when a distinct clinical problem is addressed with modifier 25

Lumps or nodules: Firm bumps that do not resolve within 2-3 weeks after injection may indicate scar tissue formation