Wiki Difference between 96372 and 20552

[jschmutz]

Hi Everyone,

Can anyone tell me the difference between CPT 96372 and 20552 and under which circumstances you would use one over the other?

96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)

Thanks, Jen

 

[overnluv@yahoo.com]

injections

96372- Is usually used when you inject in the arm or hip muscle like for example solumedrol, rocephin, depo-testosterone, depo-medrol, vitamin b12 shots. These shots does not have to be injected in a certain muscle/trigger point for the medication to take effect ( is based on my understanding)

20552- You inject the meds to the trigger point muscle(where the patient is hurt)

Trigger point injections are anesthetic agent and/or therapeutic agent injected into the area to relax the intense muscles/relieve the pain. It requires documentation of any evaluation/process of arriving at the diagnosis of the trigger point for an individual muscle or muscles should be clearly documentated in the patient's chart. You should note the
1-History of pain, location and intensity of pain.
2-Palpable knots of muscle or taut muscle bands should be recorded
3-Range of motion restriction, production of referred pain and/or any motor dysfunction should be duly noted in patient's chart.

Once the medical necessity is established, use the appropriate ICD-9 code as your diagnosis. Always keep a record of the muscles you are injecting. Since TPI's are PER SESSION codes and NOT per injection codes, no modifiers can be used. Select the appropriate code by the no. of muscles injected. For example: If a patient presents with pain in abdominal area and physician injects 6 injections on patient's Transverse Abdominus and 4 injections on patients Rectus Abdominus, you would report CPT 20552 [Injection(s);single or multiple trigger point(s), 1 or 2 muscle(s)]. Also report the appropriate J code from the HCPCS if any therapeutic drug is used.

HOPE THIS HELPS!