DecisionHealth, DecisionHealth - 2023 Issue 4 (April)

Pinpoint requirements for trigger point injections, watch your MAC

Take your staff through the guidelines for trigger point injections (20552-20553) during your next compliance session. This pain treatment procedure has a 13% denial rate according to the latest Medicare Part B claims data, received a 98% denial rate during a medical review, and is frequently controlled by strict local coverage determinations (LCD) and private payer policies. These factors can combine to make receiving proper reimbursement for trigger point injections a painful undertaking.

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