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re cpt code :Trigger points

Zakari Posted Wed 13th of June, 2012 13:33:52 PM

What would be the supply code for 20552? do I use modifier 25 with 99214? Thank you

SuperCoder Answered Wed 13th of June, 2012 14:44:42 PM

The intent of CPT codes 20552 and 20553 is to identify the procedure of performing the trigger-point injection, regardless of whether an injectable is supplied. If an injectable is supplied, you would need to report the supply of any injectables separately by submitting the appropriate HCPCS code(s) or code 99070, “Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided).” Note that 20552 and 20553 should not be used for acupuncture procedures, which are more appropriately reported with CPT codes 97780-97781.

Yes Use Modifier 25 with 99214 to indicate that, on the day of a procedure or service identified by a CPT code, the patient’s condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed.” (CPT 2010)

A significant, separately identifiable E/M service is one with separate documentation of the components of an E/M service. Documentation should be extensive enough that the additional service is readily identifiable. The E/M service must require additional history, exam, knowledge, skill, work time, and/or risk above and beyond what is usually required for the procedure. None of the documentation components required to report an E/M service may also support the performance of the procedure itself; there must be separately identifiable documentation to report the procedure.

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