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Easily code Trigger Point Injections Cpt code
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Basics about Trigger Point Injections Cpt code 20552


In Intervenational radiology Trigger Point Injections Cpt code are very difficult to code. To understand the documentation to code Trigger Point Injections Cpt code takes a lot of time. But first we will check about code Trigger Point Injections. Trigger point injections are muscle injections used to relieve trigger point pain. For relieving pain we also perform injection, drainage, aspiration in spinal cord or injection in large or small joints. Medications used are local anesthetics, anti-inflammatories, corticosteroids, and/or normal saline to relax the area of intense muscle spasm. Trigger points are focal hyperirritable spots located in a knot of skeletal muscle. These knots are painful on compression and can produce referred pain and a local twitch response when pressure is applied. Some frequent causes include acute trauma, repetitive movement muscle injuries, poor posture, pinched nerves, stress and lack of exercise. Muscles frequently affected are the neck, shoulders, and pelvic girdle. Head and neck region trigger points can manifest as tension headaches, tinnitus, temporomandibular joint point pain, eye symptoms, and torticollis. Upper limb pain may resemble visceral pain, tendonitis or bursitis while gluteus maximus and gluteus medius often produce low back region pain. Trigger Point Injections Cpt code 20552 and 20553 should be used correctly while coding medical charts.

Procedure Description
CPT code
Injection (s): single or multiple trigger point (s), one or two muscle (s)

20552
Injection (s); single or multiple trigger point (s), three or more muscle (s)

20553

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Coding tips for Trigger Point Injections Cpt code 20552

History and Physical: A detailed report noting the onset of the painful condition with its presumed cause. Clinical features often present are a referred pain distribution pattern, restriction in movement and focal tenderness. The physical examination should indicate the location of a band of muscle or knot that is palpable with the reproduction of pain upon stimulation. Documentation of prior non invasive treatments attempted but not successful in alleviating the symptoms should be noted. Final note/Summary: The final note should indicate the procedure performed with post procedure pain relief and/or complications noted.
Indications / Associated Pathology:
  • Injuries (eg whiplash)
  • Myofascial Pain Syndrome
  • Repetitive movement injuries
  • Fibromyalgia
  • Tension headaches
Trigger point injections cpt code group to APC 204 with a status indicator of “T”.
Imaging guidance reported (CPT codes 76942, 77002, 77021) is not paid separately.

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More tips for Cpt code 20552


Only one trigger point injection procedure should be reported on a particular day, no matter how many sites or regions are injected. If image guidance is used report CPT codes 76942, 77002 or 77021 in addition to 20552 or 20553. Trigger point injections are coded for paravertebral facet (zygapophyseal) joint injections if imaging guidance and localization is not used during the procedure. Clinical Example, CPT code 20552: After identification of the trigger point in the multifidus muscle left of the L5 spinous process by palpation, a 1.5 to 2-in, 25-gauge needle is inserted through the skin into the muscle. The needle is advanced a short distance, about 2 to 4 cm, observing any complaints of paresthesia while searching for the area of maximum tenderness. If any complaints or paresthesia are encountered the needle is withdrawn slightly until the complaints or paresthesia stop. Next the injectant solution is infiltrated in a fanwise method into the trigger point after aspiration is negative for blood. The solution is usually a mixture of 1 to 5 cc of anesthetic containing a corticosteroid. Post procedure the area is cleansed and a bandage applied to the site. Clinical Example, CPT code 20553: After identification of three trigger points by palpation, a 1.5 to 2-in, 25 gauge needle is inserted through the skin into the muscles. The needle is advanced a short distance, about 1 to 3 cm, observing any complaints of paresthesia while searching for the areas of maximum tenderness. If any complaints or paresthesia are encountered, the needle is withdrawn slightly until the complaints stop. Next, 1 to 3 cc of the injectant solution is infiltrated in a fanwise method into the trigger points after aspiration is negative for blood. Post procedure area is cleansed and a bandage applied to the area.
Hope, now you can easily reach to code Trigger Point Injections Cpt code without any confusion.

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5 comments

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25 September 2014 at 04:40 delete

Very nice and very helpful post on code trigger i read it very carefully .Thanks for sharing such a great post with us.I like this website a lot for it's very helpful posts

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25 September 2014 at 08:40 delete

thanks naveen....keep visiting for more helpful posts

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9 June 2015 at 06:04 delete

I am billing 20552 with 76942 and J2000 and I am getting denied as " this code requires use of an entity code". Any help is appreciated:)

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9 June 2015 at 06:05 delete

I am billing 20552 with 76942 and J2000 and I am getting denied as " this code requires use of an entity code". Any help is appreciated:)

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10 June 2015 at 06:57 delete

hi dee, I think 76942 is not separately payable with cpt code 20552.....may be this is reason it is getting denied..do check once again......and thanks for visiting my blog and commmenting on trigger point injections coding

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