# piriformis muscle injection



## millortsui (Mar 25, 2011)

Hi there,

What pain code will you use?  Will you use 64614?  or 64999?

Please advice.

thanks,
Millor


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## marvelh (Mar 25, 2011)

What is being injected?  64614 would only be used if one of the botulinum toxins were injected.

Some providers consider this to be a trigger point injection (20552) as it is often performed to try to treat the spasm in the piriformis muscle


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## millortsui (Apr 1, 2011)

thanks!


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## purplescarf23 (Apr 13, 2011)

Our docs use the 64999.  We us an alpha at the end and use box 19 to describe what the MD performed.  We use the 355.0 for the dx.  When in doubt query the provider to get more specific on what they consider the procedure is. 

Kelsey, CPC


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## hgolfos (Apr 22, 2011)

There is another post in the ASC forum about piriformis injections... 

I have been unable to find a consensus on what is the appropriate way to bill these.  Using the trigger point code seems the most logical choice, however 355.0 does not establish medical necessity for that code with our Medicare carrier.  I would be eternally grateful for any other guidance or references anyone can offer.

also, 64999 is an unlisted nervous system code, which, if the provider isn't blocking a nerve, is technically incorrect.  If the provider is blocking either the peripheral nerve associated with the piriformis muscle or the sciatic the codes for one of those may be more appropriate...


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## purplescarf23 (Apr 26, 2011)

also, 64999 is an unlisted nervous system code, which, if the provider isn't blocking a nerve, is technically incorrect.  If the provider is blocking either the peripheral nerve associated with the piriformis muscle or the sciatic the codes for one of those may be more appropriate...[/QUOTE]

We get paid for the 64999 so it just depends like you said what the provider is documenting.


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