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Piriformis muscle injection

  1. Default
    Medical Coding Books
    You should not change the procedure based on coverage criteria! You must code for the procedure that was actually performed. Piriformis "muscle" injection is a trigger point and should be billed as 20552 (if multiple injections are done). Perhaps you should query your documentation or your provider for additional diagnosis that might meet your medical necessity or educate the providers on what documentation is required for coverage-but you should never change the procedure or diagnosis simply for coverage.

  2. Default
    Thanks for your input. I certainly wasn't implying that I should "change" the code based on coverage criteria. The fact of the matter is, not everyone agrees that 20552 is the correct code for a piriformis injection. There is not a code specifically for this, and there is no official guidance that I can find anywhere. I have done quite a bit of research on it, and frankly the jury is still out on how to code these.

  3. #13
    Albany, New York
    Hello All......

    Just happened to come across this thread while searching for something else......

    Please see link below:

    In the majority of the scenarios I have coded for this injection, the documentation
    supports CPT 20999.
    Karen Maloney, CPC
    Data Quality Specialist

  4. Default
    We diagnose using 729.1 primary, 355.0 second for Medicare payers. We also bill 20552 for injection into the piriformis muscle which is usually documented as part of the procedure note.

  5. #15

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