Stupid CMS Codes by Michael Gorback MD


It’s early so we may have some other good candidates for Stupidest Coding of the Year but here goes: Novitas, the CMS carrier for TX, only allows the following ICD-9 codes for trigger point injections:

723.1 Cervicalgia (translation: neck pain that [1] I couldn’t figure out or [2] didn’t take the time to figure out)
723.9 Unspecified musculoskeletal disorders and symptoms referable to neck (translation: cervicalgia)
724.1 Pain in Thoracic spine (translation: cervicalgia in the thoracic spine)
724.2 Lumbago (translation: cervicalgia in the lumbar spine. Does ANYONE who graduated medical school after 1940 use that term?)
726.19 Other unspecified disorders of bursae and tendons in shoulder region (When did bursae and tendons become trigger point generators?)
729.1 Myalgia and myositis unspecified (translation: cervicalgia of anything, or maybe polymyositis, Guillian-Barre, or post-polio syndrome)

Arms, legs, hips – who knows? I guess they go into 729.1

I’m sure that ICD-10 will fix this and we can code for “Unspecified musculoskeletal disorders and symptoms referable to neck due to being hit by falling spacecraft parts, initial encounter”

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “Stupid CMS Codes by Michael Gorback MD

  1. branden Tarlow
    January 21, 2015 at 5:18 pm

    Seems appropriate to me. doesn’t it reflect the lack of evidence for trigger point injections? Perhaps refer to a chiropractor? or stop doing trigger point injections?

  2. Kris
    January 21, 2015 at 12:28 pm

    I’ve always liked that the ICD-9 code for low-back pain was linked to “lumbago.” There’s something quaint and historic about the word and it does really mean pain in the low back. Low-back pain in the ICD-10 (M54.5) is just called low-back pain. Lumbago is now paired up with sciatica for M54.4-. The logic of all this escapes me and why can’t there just be a code for “Trigger-point injection deficiency?”

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