Can 76942 be billed more than once per session during trigger-point injections (e.g., 20553) if multiple areas are injected, or should it be one 76942 per session?
Code 76942 can be billed with trigger point injections (e.g., 20553), but only assign the code once per session in accordance with the NCCI policy. The most current guidance at the time of publication in the National Correct Coding Initiative Policy for Medicare Services (Chapter 9, Section G, subsection 3) states the following: “CPT codes 76942, 77002, 77003, 77012, and 77021 describe radiologic guidance for needle placement by different modalities. CMS payment policy allows one unit of service for any of these codes at a single patient encounter regardless of the number of needle placements performed. The unit of service for these codes is the patient encounter, not number of lesions, number of aspirations, number of biopsies, number of injections, or number of localizations.”
This question was answered in our Breast & Bone Density Procedure Coding Guide. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.