Billing and Coding: Trigger Point Injections (TPI)

Trigger point injections (CPT 20552 for 1–2 muscles, 20553 for ≥3 muscles) are covered up to 3 sessions in a rolling 12 months; dry needling and acupuncture are excluded, modifier 50 must not be reported with 20552/20553, and NCCI/OPPS edits may apply. Key requirements: medications billed on the same claim with appropriate J- or revenue code (unclassified J-codes need drug name/dose in Box 19), all injections into a muscle group are included in the CPT code (not billed separately), complete legible patient records must be maintained, and non-covered services must be billed with the proper modifier.