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The answer to can you bill cpt code 20610 twice in a single encounter depends on whether the two procedures were performed on different joints: two different joints mean two separately reportable units of CPT 20610 with appropriate modifiers, while the same joint treated twice means one unit regardless of how many times the needle was inserted

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A series of recent studies implicated sirtuins as potent negative regulators of fibroblast activation and myofibroblast differentiation, and sirtuin dysfunction has been linked to the pathogenesis of SSc and other fibro-inflammatory conditions 28,29,38,39,40,41,42