AAPC - Back to school
Results 1 to 4 of 4

Thread: trigger point denial

  1. #1

    Default trigger point denial

    AAPC: Back to School
    Can someone help me with the following:

    pain mgmt: pt had two levels of facet joint injection with fluoro., as well as 1 trigger point injection. United HealthCare has denied the 20052 for the reason that it is not a seperately reimbursable srvc

    Should modifier 59 be attached to 20552


  2. #2


    yes add modifier 59

  3. #3


    you may also want to look at your diagnosis code to support medical necessity for the TPI. Just a thought~

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    Agree the 59 modifier and look at dx, I have seen claims where inadvertantly all dx were linked to each procedure which did cause line items to deny for medical necessity.

Similar Threads

  1. Trigger Point
    By mallorymartinelli in forum Billing/Reimbursement
    Replies: 1
    Last Post: 04-08-2015, 10:56 AM
  2. Trigger Point??????
    By graceroni13 in forum Diagnosis Coding
    Replies: 4
    Last Post: 08-26-2014, 01:43 PM
  3. Trigger Point
    By missyah20 in forum Diagnosis Coding
    Replies: 2
    Last Post: 01-24-2013, 05:09 PM
  4. Trigger point
    By mamacase1 in forum Orthopaedics
    Replies: 3
    Last Post: 09-27-2011, 11:10 AM
  5. Trigger point
    By TrinaKnight123 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 09-22-2010, 12:58 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.