Orthopedic Coding Alert

Question: We occasionally use Botox for trigger point injections for pain management. My predecessor coded these as 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) rather than using the trigger point injection codes. Is there any rationale for coding this way?

Oregon Subscriber

Answer: In 2002, CPT introduced two codes specifically for trigger point injections: 20552 (Injection; single or multiple trigger point[s], one or two muscle group[s]) and 20553 ( single or multiple trigger point[s], three or more muscle groups). These are the appropriate codes to use when Botox is administered for pain management. The drug is billed with J0585 (Botulinum toxin type A, per unit).

The answers for You Be the Coder and Reader Questions were provided by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopedic Associates in New Brunswick, N.J.