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Trigger Point Injections-I do billing for

metzger130

Networker
Messages
66
Best answers
0
I do billing for pain management and have a question when it comes to Trigger Point Injections. The provider wants to know what ICD9 codes would work for Lumbar and Thoracic. I am looking at the Ohio Medicare LCD and not getting very far in finding something. What do others use for Lumbar or thoracic area when it comes to trigger point injections?

Thanks,
Rob
 

AngelaMehl

Contributor
Messages
16
Location
Tulsa, Oklahoma 91802
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I am in Oklahoma and 724.2 is a covered diagnosis for a trigger point in the lumbar spine. There are only a handful of covered diagnoses but another one I use is 729.1 myalgia and myositis, unspecified. Neck pain 723.1 is usually covered. I have one doctor who insists on using the 728.85 for muscle spasm and Medicare will not cover that dx. 724.1, thoracic pain is generally covered. Here is a good list but keep in mind that every payable code is carrier specific. I worked in pain management for a long time and we actually got reimbursed using the 338 series for chronic pain. Good luck to you!:)

729.1 Myalgia and myositis, unspecified
720.1 Spinal enthesopathy
724.2 Lumbago
728.85 Spasm of muscle
723.1 Cervicalgia
724.5 Backache, unspecified
723.9 Unspecified musculoskeletal disorders and symptoms...
726.5 Enthesopathy of hip region
719.41 Pain in joint; shoulder region
724.4 Thoracic or lumbosacral neuritis or radiculitis, u...
726.19 Rotator cuff syndrome of shoulder and allied disor...
726.90 Enthesopathy of unspecified site
727.03 Trigger finger (acquired)
729.5 Pain in limb
722.52 Degeneration of thoracic or lumbar intervertebral ...
726.10 Disorders of bursae and tendons in shoulder region
724.3 Sciatica
719.45 Pain in joint; pelvic region and thigh
729.0 Rheumatism, unspecified and fibrositis
729.2 Neuralgia, neuritis, and radiculitis, unspecified
721.3 Lumbosacral spondylosis without myelopathy
724.1 Pain in thoracic spine
720.2 Sacroiliitis, not elsewhere classified
847.0 Sprains and strains of other and unspecified parts...
719.46 Pain in joint; lower leg
724.02 Spinal stenosis, lumbar region
 
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AngelaMehl

Contributor
Messages
16
Location
Tulsa, Oklahoma 91802
Best answers
0
I do billing for pain management and have a question when it comes to Trigger Point Injections. The provider wants to know what ICD9 codes would work for Lumbar and Thoracic. I am looking at the Ohio Medicare LCD and not getting very far in finding something. What do others use for Lumbar or thoracic area when it comes to trigger point injections?

Thanks,
Rob
have found that my physicians respond better when I show them something in writing form a reputable source that shows them the dx codes that answer their questions. For example, print the LCD for each procedure in question so they have a hard copy of the payable diagnoses. Wishing you the very best :D
 

metzger130

Networker
Messages
66
Best answers
0
AngelaMehl, I wish I was in Oklahoma looking at that list! Our Ohio acceptable per the MCR LCD that I printed 3-13-15 is much smaller than your list.
720.1 Spinal Enthesopathy
723.9 Unsp musculosk dis. and symp referable to neck
726.19 Other spec. disorders of bursae and tendons of shoulder region
726.39 Other enthesopathy of elbow Region
726.5 Enthesopathy of Hip Region
726-71 - 726.72 Achilles Bursitis or Tendinitis - Tibialis Tendinitis
726.79 Other Enthesopathy of Ankle and Tarsus
726.90 Enthesopathy of Unspec. site
729.0 Rheumatism Unsp and Fibrosis
729.1 Myalgia and Myositis Unsp.
729.4 Fascitis Unsp

That's what they have for good codes for 20552 and 20553. I have printed out the LCD from Medicare TWICE for the Physician and he still insists on putting 728.85 as the diagnosis code. It's a battle trying to get him to understand that 728.85 is not going to work for Medicare and many other carriers. Thanks for the good luck wishes, I have a feeling I might need them!
 
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