tci Outpatient Facility Coding Alert - 2015 Issue 11

Reader Question: Tie the Trigger Point Injections With 20552 and 20553

Question: A patient suffered whiplash from crashing his car into a parked vehicle, and the physician performed trigger point injections to four sites to treat the condition. Based on our charge sheet, I reported 20552x2 and got a denial for the second code. Why? The descriptor for 20552 states “one or two muscle[s],” so I thought four muscles meant reporting the code twice. Illinois Subscriber Answer: For four muscles, the appropriate code is 20553 (Injection[s]; single or multiple trigger point[s], 3 or more muscle[s]). You should use 20552 (…single or multiple trigger point[s], one or two...

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