Wiki Trigger point injections

[crystal@northgorgiapainclinic.com]

I am having an issue with trigger point injections denials through Medicare. One of our providers does a fairly large number of these and I have usually coded 20553 with diagnosis of M62.830 (paraspinal muscle spasm) These have always been covered under Medicare but I am now starting to get denials for medical necessity. I have looked up the LDC but no approved dx are listed. Is anyone else having this same problem?

 

[becca051]

trigger point

our encoder shows the following dx meet medical necessity.

M46.01 - M46.09, M53.82, M60.811 - M60.812, M60.821 - M60.822, M60.831 - M60.832, M60.841 - M60.842, M60.851 - M60.852, M60.861 - M60.862, M60.871 - M60.872, M60.88 - M60.89, M75.81 - M75.82, M76.31 - M76.32, M76.811 - M76.812, M77.51 - M77.52, M77.9, M79.0 - M79.1 or M79.7


thanks!

 

[crystal@northgorgiapainclinic.com]

Thank you!