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Thread: Paine Management Medicare denials for trigger point injections

  1. #1
    Join Date
    Apr 2007

    Cool Paine Management Medicare denials for trigger point injections

    AAPC: Back to School
    Does anyone know why Medicare will deny payment for professional fees related to a toradol injection or trigger point injections? We have a pain clinic with a contracted pain group within a hospital and Medicare will not pay for 96372, 20553 or 96374 even though there is a fee listed for our situation on the CMS code fee schedule. Is there something else we need to be doing?

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    why are you billing 96372 and 96374 for trigger point injections?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007


    Also, you may be hitting medical necessity for your trigger point (20553). Many Medicare carriers have an LCD regarding Trigger Point Injections.
    Missy Heuer CPC, CANPC

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