2024 Trigger finger injection cpt

No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately.. Us marshals list

Feb 3, 2011 · 6. Best answers. 0. Feb 8, 2011. #4. 20550 says "injection (s) of a single tendon sheath...) the coding tips in the coding companion state that if more than one tendon is injected in the same incounter, each injection should be reported separately. You can bill 20550 more than once during the same encounter. There are two CPT ® codes for Trigger point injections: 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553-Injection (s); single or multiple trigger point (s), 3 or more muscles. Local anesthesia is included in these services. However, imaging guidance can be billed in addition to the injection if necessary ... Trigger finger 3 mL 25 gauge, 0.5 to 1 mL of 1% lidocaine or 0.5 mL Celestone Soluspan or ... †—A hemostat is needed to immobilize the needle when performing injection following aspiration ...Jul 23, 2021 ... Trigger finger is an extremely common condition. Injection of steroid is commonly used for treating this condition.Aspiration and Injection CPT Codes. Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) Injection, therapeutic; carpal tunnel (20526) Injection, therapeutic; single tendon origin or insertion (20551) Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) Arthrocentesis ...Medicare does not cover Prolotherapy. Its billing under the trigger point injection code is a misrepresentation of the actual service rendered. When a given site is injected, it will be considered one injection service, regardless of the number of injections administered. Utilization GuidelinesThe codes for reporting TPs include: Injection (s); single or multiple trigger point (s); 20552 1 or 2 muscle (s) 20553 3 or more muscles. Modifiers and Units. Modifiers: Although it may seem logical to report modifiers RT, LT, or 59, the code descriptions clearly identify the codes for 1-2 muscles injected or 3 or more muscles injected, making ...The 2024 edition of ICD-10-CM M65.30 became effective on October 1, 2023. This is the American ICD-10-CM version of M65.30 - other international versions of ICD-10 M65.30 may differ. Convert M65.30 to ICD-9-CM. Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.Red toes can be a symptom of Raynaud’s disease, according to Mayo Clinic. In some cases, when the disease is triggered and the body warms up, toes or fingers may turn red, throb or...To date, my two hand surgeons have never required ultrasound for a trigger injection. It sounds like your physician is using ultrasound routinely. The codes may not hit an edit, but before I would bill it out I would want the physician to document the medical necessity for the ultrasound to guide the needle for the patient.Dear Editor, Stenosing tenosynovitis, or trigger finger, is an inflammation and swelling of the retinacular sheath that progressively restricts the motion of the flexor tendons [].This sheath normally forms a pulley system in each digit that functions to maximize the flexor tendon’s force and efficiency [].The first annular pulley (A1) at the …A bilateral pudendal block was given under finger guidance into the Alcock’s canal. ... ileococcygeus, coccygeus and puborectalis muscles bilaterally. The provider has documented the injections as trigger point injections. However, when injecting a toxin such as botulinum, is it more appropriate to assign a code for chemodenervation from …Sep 15, 2005 · M65.30 Trigger finger, unspecified finger M65.311 – M65.359 Trigger finger M65.4 Radial styloid tenosynovitis [de Quervain] M65.80 Other synovitis and tenosynovitis, unspecified site M65.811 – M65.9 Other synovitis and tenosynovitis M65.841 – M65.849 Other synovitis and tenosynovitis, hand Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection?No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. ... Pain in right finger(s) M79.645 Pain in left finger(s ...Background The purpose of the present study was to evaluate the clinical effectiveness of ultrasonography-guided needle release of A1 pulley combined with corticosteroid injection by comparing it with ultrasound-guided needle release of the A1 pulley alone. Methods A total of 49 patients (55 fingers, thumb) with trigger fingers …Trigger finger (727.03) Ganglion of tendon sheath (727.42) Contracture of joint, hand/fingers (718.44) Loc prim osteoarthritis, hand (715.14) Pain in joint, hand (719.44) CPT Codes Injection, tendon sheath, ligament, trigger points or ganglion cyst (20550) Aspiration or injection ganglion cyst (20612)If it's a general intramuscular injection, then it's 96372. If it's into a major joint (shoulder, hip, knee, subacromial bursa), then it's 20610. Other joints are small joints (fingers, toes) - 20600 and intermediate joints (wrist, ankle, elbow, acromioclavicular - 20605). Trigger points have their own codes. Kenalog is billed per 10mg.The most common symptoms of trigger finger include: A snapping or popping feeling when you move your fingers or thumb. It might feel like your affected digits are “catching” or getting stuck as they move. Pain and stiffness when flexing your fingers or thumb in toward your palm. Soreness in your palm near the base of your fingers or thumb.Before injection of the first carpometacarpal joint, 3.0 to 5.0 mL of 1.0 percent lidocaine (Xylocaine) may be injected around this nerve with a pre-frozen 30-gauge needle, 2 with caution not to ...Remember that the injection is in the origin, where the tendon connects with the muscle. So, what exactly is the trigger point injection CPT code? 20552 What is the procedure for injecting a trigger finger? Liquid corticosteroids are injected into the tendon sheath at the base of the affected finger or thumb in cases of trigger finger.Get Dx Just Right on Trigger Finger Injection. Question: Encounter notes indicate that the provider saw a patient in the office for pain in her finger. After an evaluation and management (E/M) service that included low medical decision making (MDM) and lasted 27 minutes, the provider diagnosed trigger finger. They then performed a tendon …The coding advice may or may not be outdated. Injection at A1 pulley. Date: May 26, 2021. Question: Can you please confirm the accurate CPT code for injection at the A1 pulley for trigger finger? This is an example of the documentation, "bilateral trigger finger injections provided for both long fingers at A1 pulley." Would 20550 or …Learn how to bill and code trigger point injections for myofascial pain relief by physical therapists and pain management professionals. Find out the CPT codes, modifiers, units, and ICD-10-CM codes for this procedure.Best answers. 0. Mar 17, 2016. #1. My physician did bilateral trigger finger injections on the rt and lt 3rd digit and rt and lt 4th digits. He bill 20550-50 X1 unit. 20550 has an MUE of …Trigger Finger Release Technique. Prep and drape in standard sterile fashion. Local anesthetic injected into skin and flexor sheath. Longitudinal incision over A1 pully between the distal transverse palmar crease and the base of the finger flexion crease. Blunt dissection under loop magnification down to A1 pulley.No more than 3 Trigger point injection sessions in a rolling 12 months will be considered reasonable and necessary, regardless of the code billed. CPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately.A more recent article on joint and soft tissue injections is available.. Am Fam Physician. 2002;66(2):283-289 A patient information handout about joint and soft tissue injection, written by the ...A forum thread where a user asks for help with coding a procedure of injecting kenalog and lidocaine into the flexor tendon sheaths of the trigger fingers. Two experts …This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35010, Trigger Point Injections. Please refer to the LCD for reasonable and necessary requirements. Coding Guidance. Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if ...We would like to show you a description here but the site won’t allow us.Best answers. 0. Mar 17, 2016. #1. My physician did bilateral trigger finger injections on the rt and lt 3rd digit and rt and lt 4th digits. He bill 20550-50 X1 unit. 20550 has an MUE of …This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35010, Trigger Point Injections. Please refer to the LCD for reasonable and necessary requirements. Coding Guidance. Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire …CPT 20550 is used to describe the injection of a single tendon sheath, ligament, or aponeurosis. This procedure involves the administration of corticosteroid, anesthetic, or anti-inflammatory drugs into the aponeurosis of the tendon sheath and/or ligament. It is commonly used to reduce the formation of aponeurosis and provide therapeutic relief ...There are two CPT ® codes for Trigger point injections: 20552-Injection (s); single or multiple trigger point (s), 1 or 2 muscle (s) 20553-Injection (s); single or multiple trigger point (s), 3 or more muscles. Local anesthesia is included in these services. However, imaging guidance can be billed in addition to the injection if necessary ...Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection?Mar 13, 2021 ... FLEXOR TENDONITIS / TRIGGER FINGER INJECTION - Simulation Series. RheumTutor•624 ... FLEXOR TENDONITIS / TRIGGER FINGER INJECTION - In-Vivo Series.It is appropriate to bill the 20551 CPT code when the provider performs an injection into the tendon origin or insertion site to treat pain, inflammation, and swelling caused by a diseased or damaged tendon. This code should not be used for injections directly into a tendon sheath. 6. Documentation requirements.The diagnosis is usually 727.05 (Other tenosynovitis of hand and wrist) or 727.03 (Trigger finger [acquired]). Florida Subscriber Answer: The diagnoses you offered indicate that the orthopedist is probably injecting the tendon sheath or ligament, which would point to 20550* ( Injection; tendon sheath, ligament, ganglion cyst ).Trigger finger 3 mL 25 gauge, 0.5 to 1 mL of 1% lidocaine or 0.5 mL Celestone Soluspan or ... †—A hemostat is needed to immobilize the needle when performing injection following aspiration ...Article Guidance. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33912, Injection of Trigger Points. Please refer to the LCD for reasonable and necessary requirements. Coding Guidelines.High-quality evidence supports the use of corticosteroid injections for adhesive capsulitis, de Quervain tenosynovitis, and trigger finger. 13 – 17 In a systematic review and network meta ...The finger will be numb for an hour. Sometimes the triggering increases due to the volume of fluid but this rapidly resolves. For further information, refer to Hand Injections – General. Tips for the administration of injections for the treatment of Trigger Fingers. Palpate the flexor sheath and mark the line with your thumb nail.www.MPSurgery.comwww.hand411.comHere is a good little video on how to inject a trigger finger with steroid in the clinic.Inject interdigital Neuroma Destruction of Interdigital Nerve (via injection, etc.) requires at least 50% alcohol solution. (64640 does not seem to be the appropriate. CPT code. for sclerosing. injections; at least at this time) (Fanucci et. …Coverage Guidance. This policy addresses the injection of chemical substances, such as local anesthetics, steroids, sclerosing agents and/or neurolytic agents into ganglion cysts, tendon sheaths, tendon origins/insertions, ligaments or near nerves of the feet (e.g., Morton's neuroma) to affect therapy for a pathological condition.Injection of a carpal tunnel or tarsal tunnel is indicated for the patient with a mild case of these syndromes, with or without a trial of other conservative measures, such as oral non-steroidal anti-inflammatory drugs (NSAIDs) or orthoses. Injection into tendon sheaths, ligaments, tendon origins or insertions, ganglion cysts, neuromas or other ...Spain’s Banco Santander is in the early stages of selling off yet another of its overseas subsidiaries, after the successful IPO of 25% its Mexican banking unit in the US and Mexic...Background: Trigger finger is a disease of the tendons of the hand leading to triggering (locking) of affected fingers, dysfunction, and pain. Available treatments include local injection with ...Trigger Finger Injection - Technique and Tips. Author : admin. By Chris Faubel, MD -- aka "trigger thumb injection", "trigger digit injection" ... CPT code: 205...Final word from Sportdoctorlondon about trigger finger steroid injection. A trigger finger is a common condition causing pain and clicking at the base of a finger or thumb. Simple treatments such as rest, physiotherapy, and anti-inflammatory cream help. In some cases, an ultrasound-guided trigger finger injection is very effective, and more ...Trigger Finger (trigger thumb when involving the thumb) is the inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking, catching, and locking of the digit. Diagnosis is made by physical examination with presence of active triggering and tenderness at the A1 pulley.Trigger finger, right middle finger M65.332 Trigger finger, left middle finger M65.341 Trigger finger, right ring finger ... Billing and Coding: Trigger Point Injections (TPI). 10/01/2023 R13 Based on the annual ICD-10 code update, ICD-10 code D48.1 has been deleted from Group 2. 03/19/2023 R12 The article has been revised to remove all ...Tendon sheath or Ligament: 20550 (iliolumbar ligament, trigger finger, De Quervain’s tenosynovitis, plantar fascia) Tendon origin/insertion: 20551; Trigger point injection (1 or 2 muscles): 20552; ... Also when coding injections for an in-office procedure dont forget to code for the drug and contrast. Reply. Christopher Faubel, ...The Triggers - There are a number of technologies that detect when a car has moved past a particular point in the road. Find out how. Advertisement There are a number of trigger te...Oct 3, 2018 · Article Guidance. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33912, Injection of Trigger Points. Please refer to the LCD for reasonable and necessary requirements. Coding Guidelines. © 1995-2024 by the American Academy of Orthopaedic Surgeons. "All Rights Reserved." This website and its contents may not be reproduced in whole or in part without ...Injection, tendon sheath, ligament, trigger points or ganglion cyst, Inj Trigger Finger, 20550 ; Arthroplasty, interphalangeal joint; with prosthetic implant, ...Quartz is a guide to the new global economy for people in business who are excited by change. We cover business, economics, markets, finance, technology, science, design, and fashi...© 1995-2024 by the American Academy of Orthopaedic Surgeons. "All Rights Reserved." This website and its contents may not be reproduced in whole or in part without ...History/Background and/or General Information. Trigger point injection is one of many modalities utilized in the management of chronic pain. Myofascial trigger points are self-sustaining hyperirritative foci that may occur in any skeletal muscle in response to strain produced by acute or chronic overload.Conclusions: Trigger finger injections with triamcinolone demonstrate a higher rate of additional injections when compared with dexamethasone and methylprednisolone. Patients who underwent methylprednisolone injection had surgical release performed earlier and more frequently than the other 2 groups. The choice of corticosteroid significantly ...Trigger Finger Release Technique. Prep and drape in standard sterile fashion. Local anesthetic injected into skin and flexor sheath. Longitudinal incision over A1 pully between the distal transverse palmar crease and the base of the finger flexion crease. Blunt dissection under loop magnification down to A1 pulley.Jul 10, 2010 · Procedure code and description. 20550 Injection (s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia’’) 20551 Injection (s); single tendon origin/insertion. 20600 – Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance – average fee payment – $50 – $60. To ask other uestions. Pease cal 1 4 000 eect Option three times. A trigger finger injection is an injection of a mixture of local anesthetic and corticosteroid into the tendon sheath of the affected finger to help relieve the symptoms of stenosing tenosynovitis, otherwise known as trigger finger. Duration Less than 30 minutes How is it performed?In cases of trigger finger, liquid corticosteroids are injected into the base of the affected finger or thumb. Corticosteroids are thought to work by reducing swelling, allowing the tendon to move freely again. This can sometimes happen within a few days of having the injection, but it usually takes a few weeks.Coding: 20550-LT Injection (s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)-Left side. J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg x 4 units. Because this is follow-up visit with no new patient complaint or complications, you may not report a significant separately identifiable E/M service.Jul 28, 2022 · Injection of the flexor tendon in the hand is most commonly performed for the treatment of stenosing tenosynovitis. Stenosing tenosynovitis, also known as trigger finger, involves a size mismatch between a thickened or stenotic first annular (A1) pulley in the hand and the flexor tendon trying to glide through the pulley. It is appropriate to bill the 20551 CPT code when the provider performs an injection into the tendon origin or insertion site to treat pain, inflammation, and swelling caused by a diseased or damaged tendon. This code should not be used for injections directly into a tendon sheath. 6. Documentation requirements.Trigger finger is a commonly occurring hand condition that presents with symptoms of pain, clicking, locking, and catching of the finger. A common non-operative management option is corticosteroid injection. The purpose of this study was to evaluate the short-term patient response to corticosteroid injections for trigger finger. MethodsCPT 20552 limits to 1 or 2 muscles and 20553 is 3 or more muscles. The number of injections into the muscle group are not billed separately. The code includes all injections made into the muscle. Medication. The drug used for the injection must be on the same claim as the trigger point administration.Object moved to here.© 1995-2024 by the American Academy of Orthopaedic Surgeons. "All Rights Reserved." This website and its contents may not be reproduced in whole or in part without ...Use CPT 20552 and 20553 add J code for medications these are normally for trigger point injections scenario. I hope helped you. Lady T. Hi Lady T, Thank you so much for your help! I was wondering, if the provider used EMG guidance with trigger point injections, can we use add-on code 95874 (for the EMG guidance) on to 20553 (trigger …Jan 22, 2016. #6. You can bill for the drugs used for the trigger point injections. However, it varies by carrier if they will pay them. It doesn't hurt to bill it and receive your denials so you can substantiate who pays and who doesn't. You may need to create a "zero charge" bill for these drugs if you match your inventory. To ask other uestions. Pease cal 1 4 000 eect Option three times. A trigger finger injection is an injection of a mixture of local anesthetic and corticosteroid into the tendon sheath of the affected finger to help relieve the symptoms of stenosing tenosynovitis, otherwise known as trigger finger. Duration Less than 30 minutes How is it performed? Background The purpose of the present study was to evaluate the clinical effectiveness of ultrasonography-guided needle release of A1 pulley combined with corticosteroid injection by comparing it with ultrasound-guided needle release of the A1 pulley alone. Methods A total of 49 patients (55 fingers, thumb) with trigger fingers …Learn how to code trigger finger release (26055) correctly and avoid upcoding or unbundling. Find out the difference between trigger finger release and tenosynovectomy or tenolysis, and when to use finger modifiers.Tendon sheath or Ligament: 20550 (iliolumbar ligament, trigger finger, De Quervain's tenosynovitis, plantar fascia) Tendon origin/insertion: 20551 Trigger point injection (1 or 2 muscles): 20552 Trigger point injection (3 or more muscles): 20553 Sacroiliac joint (SIJ) without fluoroscopy: 20552 (billed as a trigger point injection)CPT Codes. Surgery. Surgical Procedures on the Musculoskeletal System. Surgical Procedures on the Hand and Fingers. Incision Procedures on the Hand and Fingers. 26055. 26045. 26055. 26060.This study aims to compare outcomes of A1 pulley resection versus the standard release (or division) for patients with trigger finger. We hypothesize that complete resection of the A1 pulley will result in fewer instances of scarring and potential redevelopment of the pulley and subsequent postoperative referrals to occupational therapy (OT ...After a short eval, the doctor decided to perform a trigger point injection on the thumb. The doctor is insisting on billing a 99214-25 along with the 20550 injection procedure. Is this correct coding, or should the office visit be considered as included in the procedure? Diagnosis: M65.312 Simple ROS, and exam only of the left thumb. Thanks in ...if you inject two different muscle groups you can bill for two injections. Physician discussed patient's trigger fingers: "we discussed the role of repeat injection to the ring finger and a first time injection for the small finger. Under aseptic technique, 0.5 mL of Kengalog 40mg/mL was injected into the subcutaneous area above the A1 pulley ...Clubbed fingers can occur without other illnesses but are usually symptoms of a disease that causes chronically low blood oxygen levels. Clubbed fingers can occur without other ill...

The tendons pass through the pulleys as the finger moves. The pulley at the base of the finger is called the ‘A1 pulley.’ This is the pulley that is most often involved in trigger finger.” You get trigger finger when that A1 pulley thickens or makes it tough for the flexor tendon to move through it when the finger bends.. Carnival supermarket chula vista

Before injection of the first carpometacarpal joint, 3.0 to 5.0 mL of 1.0 percent lidocaine (Xylocaine) may be injected around this nerve with a pre-frozen 30-gauge needle, 2 with caution not to ...I have a physician that did a in injection for trigger finger on both the right and left hands. The patient was also treated for other problems during the office visit. All was paid except the 2nd injection. This is how it was billed 99213/25 20550/RT-F7 20550/59-LT This was not paid j1040*2Do you have to apologize if you have COVID-19 and unknowingly exposed someone else? In early January, I contracted the virus that causes COVID-19. My symptoms were mild, but my men...This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35010, Trigger Point Injections. Please refer to the LCD for reasonable and necessary requirements. Coding Guidance. Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if ...Dear Editor, Stenosing tenosynovitis, or trigger finger, is an inflammation and swelling of the retinacular sheath that progressively restricts the motion of the flexor tendons [].This sheath normally forms a pulley system in each digit that functions to maximize the flexor tendon’s force and efficiency [].The first annular pulley (A1) at the …Do you have to apologize if you have COVID-19 and unknowingly exposed someone else? In early January, I contracted the virus that causes COVID-19. My symptoms were mild, but my men... 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) 20553 Injection(s); single or multiple trigger point(s), 3 or more muscles Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72.2. Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List each finger on separate lines on your claim and include the "F" modifier (such as F1, Left hand, second digit) to indicate the finger treated. Note: If the surgeon made two separate ...Trigger finger, also known as stenosing tenosynovitis, is a condition in which one or more of your fingers gets stuck in a bent position or straightens with a snap, like a trigger being pulled and released. Trigger finger affects the tendons in your fingers, which control movement. When straightening and bending your finger normally, the ...Jul 10, 2010 · Procedure code and description. 20550 Injection (s); single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia’’) 20551 Injection (s); single tendon origin/insertion. 20600 – Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance – average fee payment – $50 – $60. Final word from Sportdoctorlondon about trigger finger steroid injection. A trigger finger is a common condition causing pain and clicking at the base of a finger or thumb. Simple treatments such as rest, physiotherapy, and anti-inflammatory cream help. In some cases, an ultrasound-guided trigger finger injection is very effective, and more ...Article Guidance. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33912, Injection of Trigger Points. Please refer to the LCD for reasonable and necessary requirements. Coding Guidelines.Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List each finger on separate lines on your claim and include the "F" modifier (such as F1, Left hand, second digit) to indicate the finger treated. Note: If the surgeon made two separate ...Trigger ﬁnger is thought to be caused by inflammation and subsequent narrowing of the A1 pulley of the affected digit, typically the third or fourth. The A1 pulley is most often affected, but there are some reported cases where the A2 and A3 pulleys were involved [1]. It can also occur in the thumb and is then called trigger thumb. [2]The trigger point injection CPT codes are 20552 and 20553, also called a dry beedling procedure. CPT 20552 narrates injection (s) administration in a single or multiple trigger point (s) for either 1 or 2 muscles. The CPT 20553 narrates as the injection (s) is administered for single or multiple trigger point (s) for either three or more muscles.Effective March 1, 2017, Any combination of trigger point injections, CPT codes 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) and 20553 (Injection(s); single or multiple trigger point(s), 3 or more muscles), when billed >3 times in a 90-day period, for the same anatomic site, without medical necessity, will be denied..

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