Wrist, MCP & IP joint manipulation

The patient has posttraumatic ankylosis of the joints listed above. However, he used a Bier Block as opposed to general anesthesia. He manipulated and injected the wrist and manipulated the MCP & IP joints for the thumb and each finger. The carrier is BCBS of Oklahoma. As best I can tell, I can bill an E/M & 20605.
Am I off base here? Any and all help is greatly appreciated.

Thank you in advance,
Mike
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