Eli's Rehab Report
NP Performing Trigger Point Injection
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Question: We hired a nurse practitioner (NP) and arent sure if she can bill for performing a trigger point injection for a patient with shoulder pain. Can we bill for her E/M service and the injection?
North Carolina Subscriber
Answer: Nothing in Medicares regulations would restrict an NP from billing for either the injection or the E/M service. However, to bill for both, the NP would have to see the patient for a significant and separately identifiable service. For example, a patient makes an appointment because she is suffering from an arthritis flare-up. The NP evaluates the patient and writes a referral for the patient to transfer her care to a rheumatologist. In the course of the visit, the NP notes that the patients ankle is swollen, and the patient reveals that she twisted it two days ago and has had pain ever since, which she erroneously believed was related to her arthritis. The NP performs a trigger point injection to ease pain in the patients ankle, and bills for a 20550 for the trigger point injection and 99212-25 for the office visit.
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