Wiki Injection for rib muscle spasm

[lcole7465]

I have a provider that performed an injection for a Rt rib 7th muscle spasm. The provider states that he performed a trigger point injection. However, Medicare is denying for LCD for for 20552.

This is all I have for documentation: "Trigger Point: Trigger Point pain right rib 7th muscle spasm. trigger injection today resolved that."

Any input on this would be of help.

Thanks

 

[Melissa Harris CPC]

I would check your Local LCD policies to see what diagnosis codes support medical necessity for a trigger point injection. In my MAC only muscle spasms and myalgia are covered diagnoses for trigger points.

Also, I would question your provider if he injected the Costochondral joint - if so, this should be billed as a 20605, not a trigger point.

Hope this helps!


Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management