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Wiki 64418/20553

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DPAL924

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Can 64418 be billed along with 20553 as long as there is a 59 modifier on 20553?
 
Only if the trigger point injections are performed in a different anatomic location from the suprascapular nerve injection or in a different session
 
medial branch blocks w/o guidance

Thanks Marvel. Now I have a new issue...one of our Drs is doing spinal medial branch blocks WITHOUT guidance. Should this be billed as a trigger point injection, 20553, or nerve block injections? If nerve blocks should it be coded as 64405 or 64450?
 
CPT includes the following parenthetical note regarding this: "Image guidance and localization are required for the performance of paravertebral facet joint injections described by code 64490-64495. If imaging is not used, report 20552-20553"
 
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