Billing and Coding: Trigger Point Injections

Coverage for trigger point injections is determined by the reasonable and necessary clinical criteria in LCD L35010; services not meeting that LCD are not covered. Medicare billing must only report one CPT code (20552 or 20553) per patient per day regardless of number of sites injected, and non-covered services must be billed with the appropriate modifier and supporting documentation.

"Trigger point injections are covered when they meet the reasonable and necessary clinical criteria specified in Local Coverage Determination L35010."

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