Coding for Trigger Point Injections:
The trigger point codes are very specific and only has two codes.
- 20552 - Injection(s); single or multiple trigger point(s), one or two muscles
- 20553 - Single or multiple trigger points(s), three or more muscles
*** Imaging is used very RARELY.
Trigger point injections must be billed one line regardless how many injections. For instance,
if your pain doc performed trigger points on 2 muscles, report 20552 x 1 unit... (not 2 units for
2 muscles!)
CPT 20553 is NOT an add-on code!
Modifier -59 should not be used with these codes.
Modifier –25 can be appended for E/M office visit if done on the same day and such is
separate and identifiable medically necessary. Above and Beyond.
Documentation in the patient’s medical record should include proper evaluation leading to the
diagnosis of the trigger points, specific identification of the affected muscle(s). It must also be
properly documented the reason why injections are the chosen as a treatment option.
**** For more references: Consult your CPT code books. The National Correct Coding
Initiative (NCCI) and third pary payer payment policies and guidelines
**** Always refer to your local carrier's LCDs
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