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You are here: Home / Articles / Coding Corner Answers: February

Coding Corner Answers: February

February 1, 2015 • By Staff

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  1. D—To bill for an additional hour of an infusion, the infusion must be at least 31 minutes into the next hour.
  2. B—The sacroiliac joint injection CPT code is 27096: injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT), including arthrography when performed. CPT code 27096 is to be used only with CT or fluoroscopic imaging confirmation of intraarticular needle positioning. Note: If CT or fluoroscopic imaging is not performed, then CPT code 20552 is to be billed.
  3. B—Standard tubing, syringes and supplies are inclusive of all infusion procedures.
  4. D—According to CPT guidelines, for physician or other qualified healthcare professional reporting, an initial infusion is the “key or primary reason for the encounter” reported irrespective of the temporal order in which the infusion(s) or injection(s) is administered. For both the physician or other qualified healthcare professional and facility reporting, only one “initial” service code (e.g., 96365) should be reported unless the protocol or patient condition requires that two separate IV sites must be used.
  5. B—Trigger point injections are based on the number of muscles injected. The 20552 is allowed for up two muscles being injected and the 20553 is for three or more muscles. For example, if five muscles are injected, 20553 meets the requirement for what was done.

CPT definition for trigger point injections:

  • 20552 Injection(s); single of multiple trigger point(s), one or two muscle(s)
  • 20553 Single or multiple trigger point(s); or more muscles

Back to the questions.

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