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Thoracic trigger point

Mike Posted Tue 03rd of February, 2015 11:50:36 AM

What is the best code for Botox trigger point injection- Bilateral supraspinatus suprascapular region-20552 or 64646.

Diagnosis of carpal tunnel syndrome

SuperCoder Answered Wed 04th of February, 2015 02:59:02 AM

Use code 20552. It will be most appropriate for trigger point injection. Thanks !!

SuperCoder Answered Thu 05th of February, 2015 12:56:41 PM

Hi Amy- Please see the update below after further review of your question:

Injection of botulinum toxin equates to chemodenervation. It would not be appropriate to report the injections as trigger point injections. CPT has very specific criteria for reporting chemodenervation of the trunk muscles - "Trunk muscles include the erector spinae and paraspinal muscles, rectus abdominus and obliques. All other somatic muscles are extremity muscles, head muscles or neck muscles."

Neither the suprascapular or supraspinatus meet the CPT criteria for trunk muscles so it would not be appropriate to report 64646 either.

Since these muscles are of the shoulder area and not neck, many providers consider them to be part of the upper extremity and would be reported with 64642 Chemodenervation of one extremity; 1- 4 muscles.

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