READER'S QUESTION: HOW TO BILL BILATERAL TRIGGER POINT INJECTION 20552-20553

Can I Bill for a Bilateral Trigger Point Injection using CPT 20552-20553? The answer is NO. See reasons below:

I know it has always been a challenge on how do we properly bill and code for Trigger Point Injections using 20552 and 20553. Because these codes are being reported based on the number of muscles.

Let's describe these 2 injection codes:

• 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)
• 20553 Injection(s); single or multiple trigger point(s), 3 or more muscles

Many are still so confused on how to bill for Trigger Points.

Here are my Coding and Billing Tips:

1. There is NO anatomical modifier; these 2 codes are not unilateral - so modifier 50, LT or RT is not applicable;
2. Code and bill based on the number of muscles (not number of injections!)
3. You can append modifier 59 if it meets the guideline and necessity
4. Possible Imaging Used (may be any of the following):

76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)

77021
Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation