Anesthesia Coding Alert

Question: One of our physicians performs bilateral injections to the piriformis muscle, bilateral injections to the quadratus lomborum muscle, and multiple trigger point injections (TPIs) to the left femoral triangle and left pectineus muscles. He performs all of these injections during the same operative session under anesthesia. How should I code the service?

Michigan Subscriber

Answer: Code piriformis injections (as well as injections to the other muscle groups you mention) as trigger point injections. Because the physician injects multiple muscle sites at the same time, report 20553 (Injection[s]; single or multiple trigger point[s], three or more muscles). The piriformis muscle sits over the sciatic nerve, which means some coders are tempted to report the procedure as a nerve injection. This is incorrect, however, because the piriformis is not a nerve.