Wiki Trigger point injections

[tldixon@mokancomm.net]

Medicare is not paying for the trigger point injections: 20552! What else should I be using? I have been using 20552 and dx 729.1.
They are saying "not medically necessary"
Thanks for any help I can get here.....

Terri

 

[dclark7]

Not sure what MAC you have, but check for an LCD. I know that both NGS and Palmetto have LCDs for this code.

 

[tldixon@mokancomm.net]

Trigger Point Injections

Thanks for the info...I have checked the LCD, and found that the dx I used is good. I guess I will have to appeal this with them.
Thanks for your help.

 

[Lliza71]

Trigger Point Injections

Hi Terri,

I know with my MAC, Novitas in NJ, we are only allowed 3 sessions within a 3 month period. Check your limitations where you are. That may be it. We always get denied for med nec when the docs try to do more.

Good Luck!
Liza