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Trigger Point Injections

  1. Default Trigger Point Injections
    Medical Coding Books
    For anyone that bills for Pain Management, I have a question. We do Trigger Point Injections (20553) and 96372 as the injection code the medications included in the injection are: Kenalog, Torador, Dexamethasone, Orphenadrine Citrate, Marcaine and Lidocaine. We are being told by an insurance company that we can not bill for the Marcaine and Lidocaine because they do not have specific J codes and that these medications are bundled with the injection code (96372). Any help is appreciated.

  2. #2
    Default
    Local anesthetic is part of the global surgical package so that is correct advise from the insurance company. Due to this bundling the only code that exists for lidocaine is when its an IV infusion.


    Here is the Practice expense break down for 20553

    RVU.JPG
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  3. Default Trigger Point Injections
    Thank you so much for the information. We do the injections in a physician's office not a hospital setting. Would that make a difference when billing the Marcaine? Or is that also a non-billable drug? Again thank you so much for your reply.

  4. #4
    Location
    Columbia, MO
    Posts
    12,960
    Default
    when billing for this trigger point injection you can bill only the 20553 and the therapeutic medication J code. you do not bill the 96372 or the lidocaine or marcain

    Debra A. Mitchell, MSPH, CPC-H

  5. Default Trigger Point Injections
    Thank you.

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