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trigger point denial

  1. Default trigger point denial
    Medical Coding Books
    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. Default
    you may also want to look at your diagnosis code to support medical necessity for the TPI. Just a thought~

  4. #4
    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.

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