Eli's Rehab Report
'Pyriformis' Is the Same as 'Piriformis'
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Question: Which diagnosis code should I use for piriformis syndrome? I've been using a sciatic nerve diagnosis.
Michigan Subscriber
Answer: The diagnosis for piriformis syndrome is 355.0 (Lesion of sciatic nerve). You can find this code in Volume 2 (Alphabetic Index) of the ICD-9-CM book: Look under Syndrome and then Pyriformis (using the old spelling of this muscle).
Keep in mind that using this diagnosis code for a trigger point injection will not create the necessary medical necessity to allow payment from some payers.
Frequently, physicians include in their documentation the supporting information (palpable tight ropy band of muscle, trigger point, etc.) also to use 729.1 (Myalgia and myositis, unspecified). Code 729.1 does support medical necessity for most Medicare carriers.
Eli's Rehab Report
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'Pyriformis' Is the Same as 'Piriformis'
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