Wiki Trigger Point

[richelle25]

We recently transferred from Cahaba Medicare to Palmetto Medicare. I have never had an issue with our trigger point injections (20552 & 20553), but since transferring to Palmetto, I have rec'd several denials stating not medical necessity. When checking the LCD for acceptable ICD 10 codes, there are not any listed. Any suggestions on how to find the ICD 10 codes that Palmetto will accept???

Thanks!

 

[hhogancl]

Trigger points

I can’t speak for Palmetto but Novitas has a LCD specifically for Trigger Points. The primary code we use is M79.1.

 

[Orthocoderpgu]

If there is no diagnosis on the LCD...

If Palmetto does not have a diagnosis for trigger points on the LCD, it seems that Palmetto has decided not to pay for them.

 

[richelle25]

Thank you for the help!