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Trigger Point Injections

  1. Default Trigger Point Injections
    Medical Coding Books
    I was wondering if you ever use a modifier when you have an E/M along with a TPI?

    Thanks!!!
    Alicia

  2. #2
    Location
    Sioux Falls South Dakota
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    358
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    Quote Originally Posted by EnclaveMed View Post
    I was wondering if you ever use a modifier when you have an E/M along with a TPI?

    Thanks!!!
    Alicia
    If the E/M is a significant, separately identifiable E/M from the trigger point injection, you would bill it with modifier 25 on the E/M - but only if documentation supports that it is truly a separate service. If the patient was seen and evaluated at one visit and told to come back for TPI, it would not be correct to bill an E/M at the second visit; every procedure has some E/M inherent in it.

    Hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. Default
    yes it does, but say they are coming in for the pain, and the dr ask questions regarding the pain such as (when it started, and how long) etc. then he performs a small examination before deciding to do the injection...would you place -25 on there then?? Thank you so much!!!

  4. #4
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    I would have to see the actual note (de-identified, of course) before I could give an opinion as to whether or not it constituted a separate E/M.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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