tci ED Coding & Reimbursement Alert - 2009 Issue 1

Reader Questions: Count Muscles on Trigger Point Injections

Question: A patient with a history of back problems reports to the ED complaining of sharp lower back pain and aching legs. The physician discovers three trigger points in the patient's longissimus muscle, and performs therapeutic injections at each trigger point. Can I report 20553 for this encounter? Indiana SubscriberAnswer: You cannot report 20553, because the physician treated only one muscle. CPT groups trigger point codes to reflect the number of overall muscles the ED physician treats, not how many injections he performs. On the claim, report the following: - 20552 (Injection[s]; single or multiple trigger point[s], one or...

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