Cpt code for carpal tunnel injection

64721-LT. Rationale: In the CPT® Index look for Carpal Tunnel Syndrome/Decompression. 64721 is the correct code because it is the median nerve being stretched (neurolysis) to relieve the pain in the wrist for a person with carpal tunnel syndrome. Study with Quizlet and memorize flashcards containing terms like What is the term for uncontrolled ...

The patient had a right carpal tunnel procedure performed on the same day as a left thumb injection of corticosteroid. Can i bill 64721-RT and 20600-FA together without any additional modifiers since...Login. Username Forgot my Username. Password Forgot my Password. Remember Me.Apr 17, 2019 · Best answers. 0. Apr 17, 2019. #1. My physician has done an injection of Depo -Medrol and Lidocaine into the patient's cubital tunnel near the elbow. He says it is similar to the carpal tunnel injection 20526. I am not sure how to code this. I have considered 20550, and also 64450. Neither option seems to fit the service exactly. Carpal tunnel syndrome is common, and an estimated 71% of patients receive surgical intervention as their primary treatment. The estimated cost of medical care for carpal tunnel syndrome in the United States is $2 billion a year, with median lost work times of just under 30 days. Surgical treatment most often involves an open procedure.2. When billing for the injection of tarsal tunnel syndrome with CPT code 28899, please place "tarsal tunnel syndrome," in Item 19 on the CMS-1500 claim form or the electronic equivalent. 3. When injection therapies for tarsal tunnel syndromes include "Baxter's injections" and/or injections for Morton’s neuroma use CPT codes 64455 or 64632. 4 ...Anyone who has worked in any portion of the medical field has had to learn at least a little bit about CPT codes. These Current Procedural Terminology codes are used to document and report medical procedures. Take a look at this guide to le...

Carpal tunnel syndrome (CTS), compression of the median nerve lying deep under the flexor retinaculum, is the most common entrapment neuropathy of the upper limb. After a failure of conservative treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs) and splinting, interventional techniques are required. Hydrodissection is an …Hospital outpatient departments. This includes facility and doctor fees. You may need more than one doctor and additional costs may apply. More cost information. Next Steps: Use this checklist to talk to your doctor about your costs and options, find hospitals in your area, or get data on ambulatory surgical centers. Search for another procedure.Denver, CO. Best answers. 0. Apr 6, 2015. #2. For Medicare physician services, bilateral procedures should be billed with modifier 50 and 1 unit of service on 1 line item. Your denials are probably due to 20526 has a Medically Unlikely Edit limit of 1 or a maximum of 1 unit of service per date of service. G.Comparisons of differing volumes of dextrose injections for carpal tunnel syndromes have also been made. The Lin group concludes that injection with dextrose of 4 mL provides better functional outcome and pain relief vs 1ml or 2ml. 44,45 Further expansion of the perineural space and longitudinal drug spreading was observed with higher volume.Oct 1, 2015 · CPT code 28899 (unilateral procedure, foot or toe) should be billed for the injection of the tarsal tunnel. Injection of separate sites (tendon sheath, ligament or ganglion cyst) during the same encounter should be reported on a separate line of coding and must have the modifier 59 appended. Carpal Tunnel Hand Skeletal Anatomy PHALANGES – Proximal – Middle (exc. Thumb) – Distal ... Other newer CPT codes • 20527= Dupuytren’s injection of Collagenase ... Session 1A, 10-11:30 AM Friday, October 26th, 2012 Other newer CPT codesCarpal tunnel injection; Carpal tunnel release; Central venous access (internal jugular, femoral) ... CPT codes for procedures where 76942 and 76998 are covered if ...CPT Code 20600, General Surgical ... The patient had a right carpal tunnel procedure performed on the same day as a left thumb injection of corticosteroid. ... 494805, member: 654943"] The medication does not determine the injection code; the type of injection does. If it's a general intramuscular injection, then it's 96372. I... [ Read More ...

UnitedHealthcare Community Plan reimburses for injections into the tendon/tendon sheath, or ligament (CPT codes 20550, 20551) ganglion cyst (CPT code 20612), carpal tunnel or tarsal tunnel (CPT code 20526) when one of the diagnosis codes are listed on a claim denoting problems with one of these regions. UnitedHealthcare Community PlanCPT 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) 31 de mar. de 2022 ... Dr. Ebraheim's educational animated video describes the condition of carpal tunnel injection and is it safe to operative after these ...Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot.An endoscopic carpal tunnel release is reported with CPT® code 29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament. Open Approach In an open approach, an incision is made over the carpal tunnel. The ligament is divided to release pressure on the median nerve, or the nerve may be relocated to relieve the pressure.

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Reimbursement Guidelines. UnitedHealthcare Individual Exchange reimburses for injections into the tendon/tendon sheath, or ligament (CPT codes 20550, 20551) ganglion cyst …Figure 1 illustrates cutaneous innervation of the upper extremity. 1 This article, part I of a two-part series, discusses landmark and ultrasound-guided nerve blocks of the elbow and wrist. Part ...Sacroiliac (SI) Joint Injections (CPT Codes 27096 and 64451, HCPCS Code G0260) Medicare does not have a National Coverage Determination (NCD) for SI joint injections. Local Coverage Determinations (LCDs)/Local Coverage Articles (LCAs) exist and compliance with these policies is required where applicable. For specificJan 10, 2023 · The CPT(R) code to report this procedure is 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel. Both endoscopic and open carpal tunnel release surgeries are unilateral codes. To report bilateral injections, either append modifier 50 to the single code or bill the code on two lines and append modifiers RT and LT, depending on ... The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. ... CPT . 29848. Endoscopy, wrist, surgical, with release of transverse carpal ligament ... Atroshi I, Flondell M, Hofer M, Ranstam J. Methylprednisolone injections for the carpal tunnel syndrome: a randomized, placebo ...

Final note: Under ICD-9, diagnosis 354.0 (Carpal tunnel syndrome) is coupled with mononeuritis of upper limb and mononeuritis multiplex. The ICD-10 system offers more clarity with separate codes for unspecified upper, right, and left limbs, as follows: G56.00 (Carpal tunnel syndrome, unspecified upper limb)CPT code 20551 should be used when the origin or insertion of a tendon is injected, in contrast to an injection of the tendon sheath, CPT code 20550. CPT code 28899 (unilateral procedure, foot or toe) should be billed for the injection of the tarsal tunnel.CPT codes are used to document treatment options. 20526 – Injection, therapeutic; carpal tunnel; Carpal tunnel release surgery is recommended by …Dec 15, 2015 · Injections into the tendon sheath, ligament cyst, carpal tunnel and tarsal tunnel when billed with the CPT and ICD codes listed under the “Provider Billing Guidelines and Documentation” section of this policy. Covered indications may include, but are not limited to: •Ankylosing spondylitis and other inflammatory spondylopathies •Carpal ... Frequency limitations: The Company limits the frequency of carpal tunnel injections to three per side within a 365-day time period. II. Tendon sheath, ligament, or tendon injection: The Company considers tendon sheath, ligament, or tendon injection(s) (CPT Codes 20550 and 20551) medically necessary and eligible for reimbursement when the Files related to Injection, therapeutic; carpal tunnel (20526) Find Window. Type in text to find: Aspiration / Injection Codes. Aspiration and Injection CPT Codes. Injection CPT Codes. Injection related CPT Codes. Carpal Tunnel Codes. Hand Surgery CPT Codes, sorted by number. Apr 17, 2019 · Best answers. 0. Apr 17, 2019. #1. My physician has done an injection of Depo -Medrol and Lidocaine into the patient's cubital tunnel near the elbow. He says it is similar to the carpal tunnel injection 20526. I am not sure how to code this. I have considered 20550, and also 64450. Neither option seems to fit the service exactly. Surgical decompression involves release of the median nerve by cutting the transverse carpal ligament. This can be done either with an open approach or endoscopically. Mini-invasive techniques, including endoscopic and mini-open approaches, have been studied and noted to have higher learning curves for the surgeon.Short axis to the wrist and carpal tunnel structures. • Take care to angulate parallel or perpendicular to avoid anisotropy. Needle Orientation • The radial and ulnar approaches are necessary to target the desired ligaments. • Radial approach: the needle will enter medial to the radial artery and radial to the median nerve (see Fig. 18.5B

Reimbursement Guidelines. UnitedHealthcare Individual Exchange reimburses for injections into the tendon/tendon sheath, or ligament (CPT codes 20550, 20551) ganglion cyst …

CMS has made a few changes for CPM (chronic pain management) that take effect January 2023. Some of the changes include an addition of two new HCPCS management codes G3002 and G3003. These services can be billed by a physician, nurse practitioner, physician assistant, or eligible qualified health care professional.Although there is no CPT code for this service, the coding convention is to use CPT code 28899, with the notation “tarsal tunnel injection” in the narrative field. CPT code 20526 could not be used because it is specific for carpal tunnel injection and because the use of an incorrect code could generate claims issues with secondary …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) Comparisons of differing volumes of dextrose injections for carpal tunnel syndromes have also been made. The Lin group concludes that injection with dextrose of 4 mL provides better functional outcome and pain relief vs 1ml or 2ml. 44,45 Further expansion of the perineural space and longitudinal drug spreading was observed with …Updated Coding section; removed diagnoses for other mononeuropathies. 04/01/2016. Updated Description/Scope. Updated Coding section; removed diagnoses for carpal and tarsal tunnel syndromes. Reviewed. 11/05/2015. MPTAC review. Updated definitions section. Removed ICD-9 codes from Coding section. New. 05/07/2015. MPTAC review. Initial document ...Dry needle trigger point injections (CPT 20560, 20561) for Commercial and Medicaid members are not ... Carpal tunnel injection may be indicated for mild to moderate ...1) Mild carpal tunnel syndrome (CTS) (See Coding Requirements section) and has failed non-operative treatment measures within 3 months including Oral ...That depends on what you are coding for. If it carpal tunnel injection only the use only the the 20526 that is an injection administration code for injections into the carpal tunnel, where the 96372... [ Read More ]

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9 de out. de 2021 ... Mayo Clinic physiatrists discuss incisionless thread ultrasound-guided carpal tunnel release and a new approach to treatment of tendinopathy ...The official description of CPT code 64719 is: “Neuroplasty and/or transposition; ulnar nerve at wrist.” The suture will be applied in layers to the incision site after freeing the nerve, …The injection would be equivalent to CPT 20526 (carpal tunnel injection), but performed into the cubital tunnel. We have been using an unlisted code from the nervous system (64999), the ASC has been reporting an unlisted code from the musculoskeletal system (24999).Jul 1, 2020 · Survey your private payers to determine which modifier, if any, is required. 5. Our physician often dictates that he is performing “staged carpal tunnel surgeries” when bilateral carpal tunnel surgeries occur on different days. The second surgery occurs about eight weeks after the first surgery, within the first procedure’s global period. It is a misuse of therapeutic injection or aspiration CPT codes to report administration of local anesthesia for a procedure. For example, it is a misuse of CPT codes 10160 (Puncture ... 20526-20553 (Injection of carpal tunnel, tendon sheath, ligament, trigger points, etc.), 20600-20611 (Arthrocentesis) to report administration of local ...carpal tunnel Facility $59.55 5441 $261.77 $41.50 Non-Facility $81.20 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) Facility $40.78 5441 $261.77 $25.98 Non-Facility $56.30 20551 Injection(s); single tendon origin/insertion Facility $41.50 5441 $261.77 $27.43 Non-Facility $57.74 20552When billing for the injection of tarsal tunnel syndrome with CPT code 28899, please place “tarsal tunnel syndrome,” in Item 19 on the CMS-1500 claim form or the electronic equivalent. 3. When injection therapies for tarsal tunnel syndromes include “Baxter’s injections” and/or injections for Morton’s neuroma use CPT codes 64455 or ...The LCD is revised to remove CPT/HCPCS codes in the Keyword Section of the LCD. At this time 21st Century Cures Act will apply to new and revised LCDs that …Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot. ….

A57201 Article Title Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma Article Type Billing and Coding Original Effective Date 10/01/2019 Revision Effective Date N/A Revision Ending Date N/A Retirement Date N/A AMA CPT / ADA CDT / AHA NUBC Copyright StatementJul 1, 2021 · While both the codes may be attributed to a surgeon’s preference, neither are considered payable under the Centers for Medicare and Medicaid Services National Correct Coding Initiative edits. 13 A small number of physicians also indicated their routine use of a therapeutic carpal tunnel injection (code 20526), despite a lack of literature to ... Joint injection of the wrist and hand region is a useful diagnostic and therapeutic tool for the family physician. In this article, the injection procedures for carpal tunnel syndrome, de Quervain ...Here's the detailed guidelines to pain management cpt codes for 2023. Here's the detailed guidelines to pain management cpt codes for 2023 ... Injections administered into the tendon sheath or ligament are also called trigger point injections. ... Carpal tunnel (G56.00) is a condition that is often treated by an injection of steroids ...Dec 8, 2020 · Hello, I hava Surgery for Carpal Tunnel with injections that I am trying to apply the modifiers correctly and am asking for some help. Procedures performed were: Rt carpal tunnel release. Left trigger thumb Left small finger trigger digit injection Left trigger thumb injection. I applied: Carpal tunnel surgery 64721 RT Carpal tunnel injection; Carpal tunnel release; Central venous access (internal jugular, femoral) ... CPT codes for procedures where 76942 and 76998 are covered if ... example, CPT codes 20526-20553 (therapeutic injection of carpal tunnel, tendon sheath, ligament, muscle trigger points) should not be reported for the administration of local anesthesia to perform another procedure. The NCCI contains many edits based on this principle. If a procedure and a separate and distinctPatients that proceeded directly to surgery were selected using the same resource as the injection cohort with selection based on a CPT code for diagnosis of carpal tunnel syndrome (ICD-9 354.0) and open carpal tunnel release (64721) or endoscopic carpal tunnel release (29848).Carpal Tunnel Injection. Indications. Carpal Tunnel Syndrome. ICD-9 code: 354.0 “carpal tunnel syndrome” ICD-10 code: G56.0 “carpal tunnel syndrome” CPT code: 20526. Materials Needed. Pen – clicking type; Gloves – non-sterile; Alcohol swabs or iodine; Band-aid; Tuberculin needle/syringe; 1-ml of 40mg/ml Depo-Medrol or Kenalog … Cpt code for carpal tunnel injection, Carpal tunnel syndrome is common, and an estimated 71% of patients receive surgical intervention as their primary treatment. The estimated cost of medical care for carpal tunnel syndrome in the United States is $2 billion a year, with median lost work times of just under 30 days. Surgical treatment most often involves an open procedure., 60650, D35.01. A patient with a malignant neoplasm of the spinal meninges is receiving a programmable pump implantation for chemotherapy. The patient is placed in the prone position where the provider made a midline incision overlying the area of the spinal cord. The reservoir was placed in the subcutaneous tissues and attached to the ..., UnitedHealthcare Community Plan reimburses for injections into the tendon/tendon sheath, or ligament (CPT codes 20550, 20551) ganglion cyst (CPT code 20612), carpal tunnel or tarsal tunnel (CPT code 20526) when one of the diagnosis codes are listed on a claim denoting problems with one of these regions., CPT codes are used to document treatment options. 20526 – Injection, therapeutic; carpal tunnel; Carpal tunnel release surgery is recommended by …, Figure 1 illustrates cutaneous innervation of the upper extremity. 1 This article, part I of a two-part series, discusses landmark and ultrasound-guided nerve blocks of the elbow and wrist. Part ..., 20526 for the CTS injection. 354.0 (Mononeuritis or of upper limb and mononeuritis multiplex; carpal tunnel syndrome) appended to 20526 and 95860 to …, Medical Coding. Orthopaedics . Carpal tunnel and guyon's canal. Thread starter wmcodylee; Start date Dec 29, 2017; W. wmcodylee Networker. Messages 61 Location New Orleans, LA Best answers 0. Dec 29, 2017 ... Does anyone ever get a carpal tunnel release and guyon's canal release in the same incision paid. I realize that they …, Injection therapies for tarsal tunnel syndrome (which include any so-called "Baxter's injections") and for Morton's neuroma (CPT code 64455) do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on ..., by injection(s) (includes imaging guidance, when performed) Facility $58.47 N/A Packaged service/ item; no separate payment made Packaged service/ item; no separate payment made Non-Facility $114.40 Musculoskeletal Medicine 20526 Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel Facility $59.55 5441 $261.77 $41.50 , If you are experiencing tingling, numbness or weakness in your hand, you could likely be suffering from carpal tunnel syndrome. Do not discount these feelings — talk to your doctor, because the earlier that carpal tunnel is diagnosed, the e..., CPT Code 20600, General Surgical Procedures on the Musculoskeletal System, General Introduction or Removal Procedures on the Musculoskeletal System - ... Carpal Tunnel and Thumb Injection. The patient had a right carpal tunnel procedure performed on the same day as a left thumb injection of corticosteroid. Can i bill 64721 …, Best answers. 0. Apr 17, 2019. #1. My physician has done an injection of Depo -Medrol and Lidocaine into the patient's cubital tunnel near the elbow. He says it is similar to the carpal tunnel injection 20526. I am not sure how to code this. I have considered 20550, and also 64450. Neither option seems to fit the service exactly., Carpal tunnel syndrome is common, and an estimated 71% of patients receive surgical intervention as their primary treatment. The estimated cost of medical care for carpal tunnel syndrome in the United States is $2 billion a year, with median lost work times of just under 30 days. Surgical treatment most often involves an open procedure., Medical Coding. Medicare Regulations . CMS Billing Carpal Tunnel Injections ... CMS Billing Carpal Tunnel Injections. Thread starter MML05; Start date Sep 16, 2014; M ..., Provider codes 64721-52 Neuroplasty, major peripheral nerve, arm of leg, open; median nerve at carpal tunnel. Provider states they use this code because 'it is the closest' to what the actual procedure is and that the hydrodissection is 75% of the work of the open procedure. I believe this is mis-coded and should code with an Unlisted Code 64999., Dry needle trigger point injections (CPT 20560, 20561) for Commercial and Medicaid members are not ... Carpal tunnel injection may be indicated for mild to moderate symptoms when pharmaceutical and other conservative measures have failed or are not otherwise indicated Tarsal tunnel Injection may be indicated for conservative …, Feb 15, 2003 · The use of local corticosteroid injection for carpal tunnel syndrome has been shown to provide greater clinical improvement in symptoms one month after injection, compared with placebo. 6, 7 Long ... , Based on the symptoms and medical history, the doctor may request any of those diagnosis tests including Tinel's sign, Wrist flexion test (or Phalen test), X-rays, Electromyography (EMG) and nerve conduction studies, Ultrasound or MRI scans. Treatment for CTS aims to reduce the pressure on the median nerve., The patient had a right carpal tunnel procedure performed on the same day as a left thumb injection of corticosteroid. Can i bill 64721-RT and 20600-FA together without any additional modifiers since... , Injection of a carpal tunnel may be indicated for the patient with mild to moderate symptoms when pharmaceutical and other conservative measures have failed or are not otherwise indicated. ... M60.871, M60.872, M60.88, M60.89 and M79.7 have been added to the Group 1: Codes for Trigger Point injections (CPT codes 20552 and …, Carpal tunnel syndrome (CTS) is a common ailment affecting the general patient population. It is the most common cause of peripheral nerve compression, with an incidence of 99 in 100,000 people. CTS is most commonly seen in patients over 40 years of age and has a greater prevalence in females. Females comprise approximately 65% to 75% of all reported cases [1]. CTS results from compression of ..., Jan 10, 2023 · The CPT(R) code to report this procedure is 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel. Both endoscopic and open carpal tunnel release surgeries are unilateral codes. To report bilateral injections, either append modifier 50 to the single code or bill the code on two lines and append modifiers RT and LT, depending on ... , Other newer CPT codes • 20527= Dupuytren’s injection of Collagenase into a cord • 26341= next –day manipulation of finger to straighten and disrupt cord American Academy of Professional Coders Session 1A, 10-11:30 AM Friday, October 26th, 2012 Other newer CPT codes 11040 & 11041 have been deleted, Background To compare the clinical effectiveness of ultrasound-guided needle release of the transverse carpal ligament (TCL) with and without corticosteroid injection in carpal tunnel syndrome (CTS). Methods From June 2016 to June 2017, 49 CTS patients (50 wrists) were included in this study. Twenty-five wrists were treated with ultrasound …, The patient had a right carpal tunnel procedure performed on the same day as a left thumb injection of corticosteroid. Can i bill 64721-RT and 20600-FA together without any additional modifiers since..., 20526 Injection, therapeutic (e.g., local anesthetic, corticosteroid) carpal tunnel 20527 Injection, enzyme (e.g., collagenase) palmar fascial cord (Dupuytren’s cord) ... when the terminology “with ultrasound/ image guidance” is not included in the injection CPT code descriptor. Modifier Use is Based on Specific Settings., A total of 21,833 patients were identified. Within this group, those who were evaluated with an EDS (CPT codes 95860, 95900, and 95904) and undergone a corticosteroid injection into the carpal tunnel (CPT code 20526, injection of carpal tunnel) prior to the surgical procedure were identified. This search yielded a total of 757 patients., Carpal Tunnel Release CPT 64721 is used to report when the procedure is performed to decompress the median nerve inside the carpal tunnel to free the nerve. While CPT 64719 will be reported when the ulnar nerve is freed. The official description of CPT code 64721 is: "Neuroplasty and/or transposition; median nerve at the carpal tunnel.", Anesthetic injection of sphenopalatine ganglion. CPT Code: _____ decompression of intact nerves. Neuroplasty is the: About us ... carpal tunnel, 63303 and more. ... CPT Code: _____ definitive. In the Surgery of Skull Base, the …, Article Text. The following billing and coding guidance is to be used with its associated Local Coverage Determination. Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot., Best answers. 0. Apr 17, 2019. #1. My physician has done an injection of Depo -Medrol and Lidocaine into the patient's cubital tunnel near the elbow. He says it is similar to the carpal tunnel injection 20526. I am not sure how to code this. I have considered 20550, and also 64450. Neither option seems to fit the service exactly., Other newer CPT codes • 20527= Dupuytren’s injection of Collagenase into a cord • 26341= next –day manipulation of finger to straighten and disrupt cord American Academy of Professional Coders Session 1A, 10-11:30 AM Friday, October 26th, 2012 Other newer CPT codes 11040 & 11041 have been deleted, Oct 29, 2010 · Carpal Tunnel Injection. Indications. Carpal Tunnel Syndrome. ICD-9 code: 354.0 “carpal tunnel syndrome” ICD-10 code: G56.0 “carpal tunnel syndrome” CPT code: 20526. Materials Needed. Pen – clicking type; Gloves – non-sterile; Alcohol swabs or iodine; Band-aid; Tuberculin needle/syringe; 1-ml of 40mg/ml Depo-Medrol or Kenalog Carpal ...