Anesthesia Coding Alert

Question: The physician administered trigger point injections to fingers 2-5 on both the patient’s hands. He coded the procedure as 20605 x 8, but I don’t think that’s correct. What should we report?

Massachusetts Subscriber

Answer:  You’re correct to question the provider’s suggestion since 20605 (Arthrocentesis, aspiration and/or injection; intermediate joint or bursa [e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa]) represents aspiration and your question states that he performed trigger point injections (TPI). The correct choices for TPI are:

·         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 muscle(s).

Notice that the codes are based on the number of muscles injected rather than the number of injections administered. Take a closer look at your provider’s documentation to determine how many muscles he injected on each finger. If 1 or 2, you’ll submit 20552 for that finger; if 3 or more, report 20553.