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Billing and Coding: Piriformis Injections
A56027
Effective: October 2, 2025
Updated: December 31, 2025
Policy Summary
This policy provides billing/coding guidance for piriformis-region injections: use CPT 20552 for injections into the piriformis or adjacent muscles and use CPT 64445 only for direct perineural sciatic nerve blocks. CPT 72195-72197 (pelvic MRI) will be denied when billed for mapping prior to piriformis-region injections, and unlisted code 64999 should not be used for piriformis injections.
Coverage Criteria Preview
Key requirements from the full policy
"When the injection target is the piriformis muscle or surrounding muscle groups (e."
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