Explore This IssueFebruary 2010
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- B—Medicare considers the local anesthetic medication to be built into the total value of the procedure.
- C—Both ways are correct. You should verify with the carriers in your area to determine which way is correct for them.
- B—If a patient is scheduled for an injection procedure and there is not a separate and significant reason for an office visit, only the procedure can be billed.
- C—Trigger points are based on the number of muscles, not the number of injections. You cannot bill for both the 20552 and the 20553; CPT does not allow for these codes to be combined for billing. If it is one or two muscles, it should be coded as 20552 only. If it is three or more muscles, it should be coded as 20553 only.
Keep in mind that these coding and billing guidelines are applicable across the board for all carriers, both private and Medicare.