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).