Medicare Guidelines for Billing and Coding: Trigger Point Injections Article A57751

When it is covered and when it is Not

As a healthcare provider, you administer treatments to your patients that you believe will be most beneficial. Under Medicare, treatments such as trigger point injections are limited to specific conditions. Medicare Article A57751 delineates the guidelines for permissible and non-permissible trigger point injections. When billing for trigger point injections, you should bill based on the number of muscles injected, not the number of injection sites. It is important not to submit a 20552 and a 20553 on the same day. If you inject two or fewer muscles, you should bill for a 20552. For injections involving three or more muscles across multiple sites, you should bill for a 20553.

The article can be accessed via the link provided below.

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57751&DocID=A57751