Wiki Trigger point injections - operative period

[todd5400]

Occasionally we are performing a trigger point injection on a patient during the post operative period. This is done for a different diagnosis. Medicare is paying the medicine code but denying the trigger point code. Does anyone know why?

Mary, CPC

 

[cmoore62]

cmoore, cpc

You need to use a 79 modifier on the trigger to keep from bundling into the surgical procedure and link to unrelated dx.

 

[todd5400]

But everything I am reading says not to use 79 for Medicare. Do you have any documentation that states this is acceptable?

Mary,CPC

 

[RebeccaWoodward*]

Mary,

Where did you read this? I have never heard of this.

Use modifier 79 to report an unrelated procedure or service by the same physician during the postoperative period.

http://www.cms.hhs.gov/Transmittals/downloads/R442CP.pdf

Page 7

 

[tmenard]

It might be the because of LCD the only payable DX for a Trigger Point is 729.1 Look at the medicare website for LCD coverage

Trish

 

[todd5400]

I need to clarify the actual procedure code I am referring to is 20610

Mary

 

[Erica1217]

20610 is for a joint injection, not a trigger point injection. If your doc is actually doing trigger points, look at codes 20552 & 20553.

Regardless, if either is done during a global period for an unrelated reason, append modifier -79.

Erica