tci Medicare Compliance & Reimbursement - 2009 Issue 22

READER QUESTION: You May Need To Bill Multiple Codes For Trigger Point Injections In The Emergency Department

Remember to document the drug that the physician injected. Question: A patient reported to the ED for treatment of severe back spasms. After a level-three E/M, the physician ordered four Trigger Point Injections (TPIs): two in the patient's multifidis, and one each in the longissimus and psoas major. How should I code for this encounter?Answer: You should first check that the patient's insurer covers TPIs for muscle spasms as acceptable ICD-9s for this service. Covered diagnoses depend entirely on the payer. Provided the payer accepts the diagnosis, report the following: • 20553 -- Injection[s]; single or multiple trigger...

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