Millions of people across the nation suffer from severe and debilitating pain. Living day in and day out with chronic pain can begin to take serious toll. Many of the people who live under such circumstances are in desperate need of effective methods of pain relief. What if you could help these people while adding to your practice's annual profits? With trigger point injections, you may be able to do just that.
Many cases of chronic pain are due to taught bands of muscles called palpable nodules. In the past, treatment for this type of pain was ineffective, to say the least. Patients would seek relief, only to be frustrated with the lack of results. Now, with trigger point injections, the patients who suffer from chronic muscle pain can experience significant relief without unnecessary side effects.
If you are looking for a way to boost your business's bottom line with minimal start-up expense, you should consider adding trigger point injections to the services you provide to your patients.
Understanding the Pre-Authorization Guidelines of Insurance Providers
If you are going to be adding trigger point injections to the services you provide to your patients, you need to understand how the pre-authorization guidelines of the various insurance providers will affect your billing procedures. Not all insurance companies share the same pre-authorization guidelines. Before you begin providing trigger point injection services, you should research the pre-authorization guidelines required by the insurance providers.
If you have a patient who needs trigger point injection treatment, contact the patient's insurance company before scheduling the procedure to inquire about what steps are required and if pre-authorization is needed for coverage of these services. While on the phone with the insurance company, also ask whether there is any cap on the number of trigger point injections a patient can receive within a set period of time. Some insurance companies place limits on the number of treatments that will be covered.
While many of the major insurance companies now cover trigger point injections, it is still always a good idea to check with each individual insurance provider prior to actually providing services to a patient. This will prevent you from holding unpaid invoices and will help your patients avoid unexpected medical bills.
A Note Regarding Diagnosis and Billing Codes
When treating patients with trigger point injections, it is important to understand the CPT codes you may be using in order to bill insurance companies for the services you are providing. These are examples of some common CPT codes you may encounter:
Description
CPT Code
Approximate Reimbursement
Injection for Carpal Tunnel Syndrome
20526
3.00
Injection for Ganglion Cyst, Tendon Sheath and Ligament
20550
.09
Procedure for One or Two Muscle Groups With One or More Multiple Injections
20552
3.20
Injections That Include at Least Three Muscle Groups
20553
3.11
When diagnosing a patient and assigning a diagnosis code, you need to be very selective about the codes you choose. For example, code 20550 was commonly used to describe each injection given to a patient, regardless of the muscle group being treated. However, auditors began "flagging" claims that used this particular code for more than one treatment. Make sure you bill using the code that accurately describes the treatment being provided.
When billing the insurance companies for a patient's trigger point injections, make sure that you understand the documentation guidelines of that patient's particular insurance provider. Most insurance companies will require that you document the medical necessity of the treatments given as well as provide progress notes that will meet the insurance company's requirements for office visit documentation. One place you can look for these guidelines is within the Local Coverage Determinations. Following these guidelines will ensure that you do not run into any trouble with the claims you submit should your charts ever be reviewed.
Boosting Revenue
Just how much revenue can trigger point injections add to your bottom line? Even if you only perform trigger point injections for ten different patients each week, your business can profit an extra ,200 to ,500 on a weekly basis. If you have ten patients that require at least five injections, you may be able to profit another ,000 weekly. It quickly becomes apparent just how lucrative this particular treatment method can be. Once you set up injection schedules for the patients who need regular trigger point injections, you can benefit from a steady flow of revenue from each patient you serve.
Whether your practice is large or small, chances are that you have quite a few patients who suffer from chronic pain. Providing your patients with trigger point injections can provide the pain relief your patients require while providing you with a lucrative revenue resource. When your patients discover that these trigger point injections are an effective form of pain relief, you can expect generate a steady level of income from your trigger point injection services.
Using CPT 20550: Can Trigger Point Injections Boost Your Bottom Line?