Trigger Point Bundling

February 16, 2017

Question:
A trigger point injection and a joint injection are bundled by Medicare. Does that mean I can’t bill both if I do both at the same encounter?

Answer:
You are correct, trigger point injection (20552 or 20553) and a joint injection, for example, a shoulder joint injection, (20610) are bundled by Medicare. You will note, however, that a modifier is allowed to override this edit. Overriding the edit is appropriate if you are doing the procedures in different anatomic locations. Therefore, doing a trigger point injection in the shoulder along with a shoulder joint injection should not be billed together. A trigger point injection in a different anatomic location, for example the back, would be separately reportable with the appropriate modifier (59 or XS).

*This response is based on the best information available as of 02/16/17.

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