Original Effective Date:
04/01/1999
Current Effective Date:
01/01/2015
Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. When stimulated, the spots produce pain locally and in a referred pattern for that individual muscle. Trigger point pain usually is treated with the injection of a combination of pain relief (e.g., Xylocaine) and anti-inflammatory (e.g., cortisone) medications into the point of greatest tenderness.
Definition
HMSA defines “muscle group” as several muscles in a region attached to a point (e.g., shoulder or knee). In accordance with this definition, the following examples may help the practitioner to determine how many muscle groups have been injected:
- If the right trapezius, supraspinatus and infraspinatus muscles are injected, one muscle group has been injected
- If both the left and right trapezius muscles have been injected, two muscle groups have been injected.
- If the left trapezius, left gluteus and plantar fascial fibromatosis are injected, three muscle groups have been injected.
Claims Filing Information
The following CPT codes represent the injection of trigger points:
| CPT Code | Description |
|---|---|
| 20552 | Injection; single or multiple trigger point(s), one or two muscle group(s) |
| 20553 | Injection; single or multiple trigger point(s), three or more muscle groups |
When filing claims for trigger point injections performed during the same visit, please use the definitions and examples listed above to determine the correct code. Please indicate the skeletal muscles being injected in Block 19 of the CMS 1500 claim form, or in the COMMENTS field for electronic media claims.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 |
|