Wiki Trigger point injections

[gail.gridley@yahoo.com]

United Healthcare and Anthem BCBS of CT will deny trigger point injections unless we bill it with the anesthetic used (Lidocaine). What we have done in the past is add J2001 to the claim and the insurance will pay for the procedure and not for the J2001 because it is considered inclusive with the procedure which is fine. But it does not seem that the J2001 should be used at all because the description states it is for "intravenous infusion"and not "injection". How do other pain specialist bill for trigger point injections and get paid?

 

[shanamarie]

United Healthcare and Anthem BCBS of CT will deny trigger point injections unless we bill it with the anesthetic used (Lidocaine). What we have done in the past is add J2001 to the claim and the insurance will pay for the procedure and not for the J2001 because it is considered inclusive with the procedure which is fine. But it does not seem that the J2001 should be used at all because the description states it is for "intravenous infusion"and not "injection". How do other pain specialist bill for trigger point injections and get paid?

We have some recent denials as well. I don’t think J2001 is appropriate but I haven’t found anything else to use. UHC has told us we should be using the dry needling codes, but that’s not correct either because we are injecting a medication.

 

[rmcperlowitz@gmail.com]

I did find information from Noridian in a draft article (A57701) that has some information on "drugs" used but didn't list those payable. Looks like maybe use unlisted J3490 (since J2001 is for IV) for the lidocaine and it being used not as an "anesthetic" but to treat the pain. Thin I know.

Billing and Coding: Trigger Point Injections (TPI) A57701

Trigger Point Injections (TPI) LCD L34211