Advanced Search

Anesthesia Coding Alert

Reader Question:

Trigger Point Injections

Published on Wed Dec 12, 2012

Question: Medicare recently denied one of my claims for trigger point injections on the grounds that the treatment was not medically necessary. I had coded 20550* (injection, tendon sheath, ligament, trigger points or ganglion cyst) for the first injection, and 20550-51 for the other five injections. The diagnosis on my original bill was 729.1 (myalgia and myositis, unspecified). I resubmitted it with diagnosis 724.2 (low back pain) and was denied again. Weve never run into this situation before. Have some of the rules for multiple trigger point injections changed? How would you recommend that we code it?

Anonymous California Subscriber


Answer: This can happen frequently to anesthesiologists. When it does, send it to Medicare Review, which requires a completed Medicare Review form and a hard-copy claim and documentation of the medical necessity of the trigger point injection. The documentation can be the [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Anesthesia Coding Alert

View All