Wiki What is the difference between 20552 and 96372

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ortho1991

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Looking for any guidance as to what the difference is between 20552 and 96372. Would appreciate any examples of what needs to be documented or dx used.

Here is a note our provider used. Using a 21 gauge needle, this was advanced under ultrasound until reaching eh iliac crest in the attachment of the gluteal muscles, 1 cc of a mixture of 8cc 1% lidocaine and 1cc Depro-Medrol 40mg was injected at 3 sites along the iliac crest. Is this 20552 or 96372?
 
First of all, what is the diagnosis for this injection? Is it a trigger point of the gluteal muscle? 20552 is specifically for trigger point (muscle) injections. Notice that the code is based on how many separate muscles were injected. If you inject the same muscle times three, it's still 20552. 96372 is for injecting things like B12 or whatever and must be paired with whatever what injected. So basically for coding this your diagnosis is probably going to tell you which direction to take.
 
This would be a trigger point since you are using a steroid into the gluteal muscle. 20552 would be the appropriate code. Also, if the patient has a Medicare product you will want to check the LCD's as trigger points have strict ICD 10 rules.

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