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WHY AM I BEING DENIED FOR TRIGGER INJECTIONS 20553 OR 20552? DIAGNOSIS 729.1

Peter Posted Wed 30th of January, 2013 02:11:33 AM

I AM BEING DENIED FOR TRIGGER INJECTIONS OFTEN. CODES 20553 OR 20552.DIAGNOSIS
729.1 FIBROMYALGIA. ARE THERE NEW CODES FOR THIS INJECTION? THERE ARE TIMES TRIGGER IS DONE WITH FACET INJECTION AND TIMES ONLY TRIGGER INJECTION IS DONE.
I STILL GET A DENIAL. CAN ANYONE HELP? IT IS WITH MOST PAYERS NOT JUST MEDICARE OR MEDICAID.

SuperCoder Answered Wed 30th of January, 2013 07:36:09 AM

Hi,
This can happen frequently to anesthesiologists. When it does, send it to Medicare Review, which requires a completed Medicare Review form and a hard-copy claim and documentation of the medical necessity of the trigger point injection. The documentation can be the doctors dictation from the procedure and/or earlier office visits detailing the patients condition. Diagnosis code 729.1 is correct for most trigger point injections, so you should leave that code on the claim. Medicare usually pays the claim after reviewing this data.
Thanks

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