Wiki Trigger Point Injection-I am getting

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metzger130

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I am getting confused on trigger point injections. I have read that you can bill for the medicine and you can't bill for the medicine being injected. Which is it and does anyone have a link that says you can, I would like to show it to the physician so I have proof of it.

Thank you,
Rob
 
Trigger point injections are under CPT 20550-20053. The code reports the actual injecting (stick) into the tendon or muscle. With administration of any injectable there is also a code for the stuff to be injected. The medicine is not included in the injection code.
 
that's what I thought, but while searching the internet I saw and Anthem site and it said that you can not bill the medicine. Probably carrier specific when it comes down to it in the end.
 
It must be. The carrier I work for covers it separately no problem. If you see it in the payment policy just print that out and you should be golden
 
One issue regarding drug coverage though may be if only a local anesthetic is injected. Many payers don't cover the local anesthetic drugs but consider it to be part of the procedure.

If a different drug such as a steroid or muscle relaxant is injected, then that is typically covered.
 
Same issue

I am having the hardest time getting insurances to pay for the actual drug itself and when I do research I get so much conflicting information. So if the CPT code states "Injection, anesthetic agent" or "Injection, diagnostic or therapeutic agent" does that mean that the drug is included in the injection code and should not be coded separately?
 
What drug are you attempting to bill for?
If it is a local anesthetic like Marcaine, Lidocaine, or Xylocaine, they are included. However, if it is a steroid like Depo Medrol, Dexamethason, or Kenalog, it is separately billiable.
 
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