CMS Trigger Point Injections Form

Summary Of Evidence

N/A

Analysis of Evidence

N/A

Indications

An active trigger point has pain at rest, has pain on palpitation, has radiation of pain, and has a local twitch response. Trigger point injections are indicated in symptomatic trigger points. The history of onset of the painful condition and its presumed cause, location, duration, failed therapies and recommendations for injection therapy of each clearly delineated muscle must be in the patient’s chart and made available to Medicare upon request. The goal is to treat the cause of the pain and not just the symptom of pain.

Limitations

1. Trigger point injections accompanied by appropriate adjunctive care should provide moderate-to-long term benefits. There is no peer-reviewed literature to substantiate more than four trigger point injections in a year.
2. Prolotherapy is not covered by Medicare. If prolotherapy is billed using trigger point therapy codes it will be considered not reasonable and necessary.