Neurology & Pain Management Coding Alert

Question: How should I code injection of trochanteric bursa and sacral crest? My physician wants to use a trigger point code, but I am thinking differently.


New Mexico Subscriber
 

Answer: The CPT code for the trochanteric bursa injection is 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]). 

You may want to check with the provider to see what he anatomically injected before deciding which code to choose for the sacral crest injection. The reason is that the sacrum also has many ligament and tendon attachments, and he could be injecting those structures rather than a trigger point in a muscle at the sacral crest.

Beside the trigger point codes 20552 (Injection[s]; single or multiple trigger points[s], one or two muscle[s]) and 20553 (... single or multiple trigger point[s], three or more muscles), you should consider codes 20550 (Injection[s]; single tendon sheath, or ligament, aponeurosis [e.g., plantar -fascia-]) or 20551 (... single tendon origin/insertion).