BILLING TIPS: How to Bill Trigger Points CPT 20552, 20553

BILLING TIPS: How to Bill Trigger Points CPT 20552, 20553

physician billing

20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)

20553 Injection(s); single or multiple trigger point(s), 3 or more muscles

Many are still so confused on how to bill for Trigger Points.

Here are my Coding and Billing Tips:

1. There is NO anatomical modifier; these 2 codes are is not unilateral
2. Choose based on number of muscles (not number of injections!)
3. You can append modifier 59 if it meets the guideline and necessity
4. Possible Imaging Used (may be any of the following):
76942

Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation
77002

Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)
77021

Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation

ICD-10 Medical Necessity:

M70.852 Other soft tissue disorders related to use, overuse and pressure, left thigh
M70.859 Other soft tissue disorders related to use, overuse and pressure, unspecified thigh
M70.861 Other soft tissue disorders related to use, overuse and pressure, right lower leg
M70.862 Other soft tissue disorders related to use, overuse and pressure, left lower leg
M70.869 Other soft tissue disorders related to use, overuse and pressure, unspecified leg
M70.871 Other soft tissue disorders related to use, overuse and pressure, right ankle and foot
M70.872 Other soft tissue disorders related to use, overuse and pressure, left ankle and foot
M70.879 Other soft tissue disorders related to use, overuse and pressure, unspecified ankle and foot
M70.88 Other soft tissue disorders related to use, overuse and pressure other site
M70.89 Other soft tissue disorders related to use, overuse and pressure multiple sites
M70.90 Unspecified soft tissue disorder related to use, overuse and pressure of unspecified site
M70.98 Unspecified soft tissue disorder related to use, overuse and pressure other
M72.2 Plantar fascial fibromatosis
M72.9 Fibroblastic disorder, unspecified
M79.1 Myalgia
M79.601 Pain in right arm
M79.602 Pain in left arm
M79.603 Pain in arm, unspecified
M79.604 Pain in right leg
M79.605 Pain in left leg
M79.606 Pain in leg, unspecified
M79.609 Pain in unspecified limb
M79.621 Pain in right upper arm
M79.622 Pain in left upper arm
M79.629 Pain in unspecified upper arm
M79.631 Pain in right forearm
M79.632 Pain in left forearm
M79.639 Pain in unspecified forearm
M79.641 Pain in right hand
M79.642 Pain in left hand
M79.643 Pain in unspecified hand
M79.644 Pain in right finger(s)
M79.645 Pain in left finger(s)
M79.646 Pain in unspecified finger(s)
M79.651 Pain in right thigh
M79.652 Pain in left thigh
M79.659 Pain in unspecified thigh
M79.661 Pain in right lower leg
M79.662 Pain in left lower leg
M79.669 Pain in unspecified lower leg
M79.671 Pain in right foot
M79.672 Pain in left foot
M79.673 Pain in unspecified foot
M79.674 Pain in right toe(s)
M79.675 Pain in left toe(s)
M79.676 Pain in unspecified toe(s)
M79.7 Fibromyalgia
M79.89 Other specified soft tissue disorders

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