Author Topic: Piriformis Injections  (Read 5756 times)

cohenmk

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Piriformis Injections
« on: July 09, 2010, 12:05:36 PM »
Hi All.....

What is the correct way to bill a piriformis injection?  I was always under the assumption that it was 20552 with 77002 for fluoro (if used), UNLESS the provider specifically states in his notes that he did either a SI joint Injection (27096) or Sciatic NB (64445).  I have seen where some code it as 64999.....  If he is doing the SI Joint Inj or NB, and the piriformis muscle...can we use both 27096/20552-59 or 64445/20552-59??

Any thoughts/comments are appreciated.
MK

oneround

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Re: Piriformis Injections
« Reply #1 on: July 09, 2010, 12:47:44 PM »

Per medAssests


When the physician performs the procedure as a block of the sciatic nerve then 64445 is appropriate. When the physician documents injection into the piriformis without mention of the sciatic nerve then 20999 would be most appropriate. Different payers may have different instructions. For example, Noridian Medicare prefers 64999 for when the injection into the piriformis without mention of the sciatic nerve is performed.

I think you may want to use 77002 for fluoroscopy in this instance. Check out CPT Assistant June 2008 on use of fluoroscopy.

NOTE: Effective 1/1/09, the facility version of NCCI edits will include edits for the following categories of service: Anesthesia (00100-01999), E&M (92002-92014, 99201-99499), and MH (90804-90911). Prior to 2009, these code pairs were excluded from the facility edits.

Code / Description  
20552  INJ TRIGGER POINT, 1/2 MUSCL M  Rel Wt: 2.56  
 
 
Code 20552 is a component of Column 1 code 27096 but a modifier is allowed in order to differentiate between the services provided.
 
27096  INJECT SACROILIAC JOINT M  Rel Wt: 0.00  
 
 
No bundling issues exist  
 




NOTE: Effective 1/1/09, the facility version of NCCI edits will include edits for the following categories of service: Anesthesia (00100-01999), E&M (92002-92014, 99201-99499), and MH (90804-90911). Prior to 2009, these code pairs were excluded from the facility edits.

Code / Description  
64445  N BLOCK INJ, SCIATIC, SNG M  Rel Wt: 7.20  
 
 
No bundling issues exist  
20552  INJ TRIGGER POINT, 1/2 MUSCL M  Rel Wt: 2.56  
 
 
Code 20552 is a component of Column 1 code 64445 but a modifier is allowed in order to differentiate between the services provided.
 
 



  
  
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

cohenmk

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Re: Piriformis Injections
« Reply #2 on: July 15, 2010, 09:00:23 AM »
Thank you for the assistance on this topic.