Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Trigger Point codes 20552, 20553 used with Acupuncture

SuperCoder Posted Fri 09th of December, 2011 20:18:43 PM

I like to mix acupuncture treatment with TP (trigger point) injections. In fact an article just came out in the last PM&R journal that compared the 2 head to head and determined that acupuncture needling was MORE EFFECTIVE on TP than the traditional lidocaine injections for the upper traps. Unfortunatly, however, Medicare doesn't pay for Acupuncture (code 97814). Is it OK to do the minimal 3 injection of TP and then do acupuncture while billing just for the TP injections (20553)? Do I have to mention the Acupuncture in the billing even if they don't pay for it?

SuperCoder Answered Fri 09th of December, 2011 21:29:56 PM

It will always preferred not to mix Acupuncture with TP while billing,as it may face rejectiona although it sounds illogical. There are instances when Medicare deny a covered service when performed along with a non-covered service.
To avoid such rejections, there is a way of billing these:
1. Bill both as you think together, but sign an ABN with the patient priorly for Acupuncture.
OR
2. Bill TP on one claim. Bill the second claim for Acupuncture separately with signing of ABN with the patient.
OR
3. Bill TP on one claim. But, bill the second claim with upfront collection of money from the patient for Acupuncture

Related Topics