# trigger point injections



## ttate (May 11, 2009)

I have been told that mod 59 is not to be used with trigger point injection codes 20552/ 20553, which makes sense, seeing as how the description explains whether it was 1-2 muscles, as in 20552, or 3 + muscles, as in 20553.  You wouldn't attach mod 59 to separate out the different muscles because they are included in the code... HOWEVER, what happens when you are performing trigger point injections along with say... 64483 (injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level). There is a different dx and documentation supports that they are separate procedures for separate reasons... wouldn't we need to attach the mod 59 to the 20552 to unbundle it from the 64483?  Where can I find the info to support or deny the usage of mod 59 on the trigger point in this situation??  any help would be great~!


----------



## magnolia1 (May 11, 2009)

The answer lies in the description of Modifer 59 in the CPT book and the documentation provided by the physician.


----------



## Abrahamtf (May 20, 2009)

*20550-64483*

I believe you can bill with a modifier 59 to separate the two codes. CPT code 20550 describes an injection in the tendon sheath or ligament (plantar fascia). Whereas, CPT code 64483 describes an injection based on levels such as injecting for a herniated disc. I ran CPT codes 64483 and 20550 trhough Encoder (CCI) and it is ok to bill with modifier 59. Would you like for me to send you the edit results? I woud also bill with (2) different ICD-9 codes to show the distinct services provided.

Tamara A.


----------



## ttate (May 20, 2009)

Thank you Tamara~!  So good to hear from you~!

I appreciate your reply... I was just verifying what I "thought" I knew...getting some support from fellow coders to make sure I was on the right track.

thank you again,
~Teresa


----------

