Billing and Coding: Trigger Point Injections (TPI)

Trigger point injections (CPT 20552 for 1–2 muscles; CPT 20553 for 3+ muscles) are covered when medically reasonable and necessary per the applicable LCD and when documentation supports the selected ICD‑10 and CPT/HCPCS codes. Coverage is limited to no more than 3 TPI sessions in a rolling 12‑month period; do not bill modifier 50 or anesthesia with 20552/20553, and biological or non‑FDA injectants may result in claim denial. All elements of the procedure, injectant name/units, muscle locations, pre/post pain relief, and required signatures must be documented in the patient medical record and medications must be billed on the same claim with appropriate HCPCS codes.

"Trigger point injections (TPIs) reported with CPT 20552 (1–2 muscles) or CPT 20553 (3+ muscles) are covered when determined medically reasonable and necessary per the applicable Local Coverage Dete..."