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Anesthesia Coding Alert

READER QUESTIONS:

Report TPI Codes for Piriformis Injection

Published on Sun Aug 21, 2005

Question: Our physician injected the patient's piriformis muscle because it was in a spasm and irritating the sciatic nerve below it. How do I code this?


Kentucky Subscriber
Answer: Because the physician indicates that he actually injected the muscle instead of the nerve, report 20552 (Injection[s]; single or multiple trigger point[s], one or two muscle[s]).

The piriformis muscle crosses on top of a portion of the sciatic nerve. A piriformis muscle spasm can create intense pain in the patient's buttock and may also progress to sciatica-type symptoms. Because of this, coders often wonder if this qualifies as a sciatic nerve block (64445, Injection, anesthetic agent; sciatic nerve, single) or a trigger point injection (20552).
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