CMM-202: Trigger Point Injections

Trigger point injections using a local anesthetic with or without steroid are medically necessary when a myofascial trigger point is documented on exam by one or more characteristic findings (referred pain, tenderness, muscle shortening, or autonomic phenomena), while injections using other substances (e.g., biopuncture/saline/glucose), dry needling, acupuncture/electro‑acupuncture, image‑guided injection over spinal hardware, same‑day regional treatments and other excluded uses are not medically necessary. Repeat injections require documentation of ≥50% pain relief with functional improvement for ≥6 weeks, documented self‑management instruction, and adherence to limits of no more than four sessions per body region per year with ≥2 months between sessions (medical necessity determined case‑by‑case).

"Repeat trigger point injections are considered medically necessary when BOTH of the following are documented: Adequate instruction or supervision in self-management strategies (i."