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The CPT® Code 20560 refers to the procedure of needle insertion(s) without injection(s) into one or two muscles. This technique is commonly known as dry needling, which is a therapeutic intervention aimed at alleviating pain associated with myofascial trigger points. These trigger points are localized areas of muscle tissue that have become tight or knotted, leading to discomfort and restricted movement. During the procedure, thin, solid-filament needles are inserted directly into the affected muscle tissue. Unlike acupuncture, which is rooted in traditional Chinese medicine and aims to balance the body's energy, dry needling specifically targets pain relief and improved range of motion. The needles may be left in place for a brief period, ranging from a few seconds to up to 30 minutes, and may be applied with or without electrical stimulation to enhance the therapeutic effect. This procedure is typically performed by qualified healthcare professionals such as physical therapists, chiropractors, acupuncturists, or physicians. It is important to note that while both dry needling and acupuncture utilize similar needles, their applications and underlying philosophies differ significantly. For coding purposes, CPT® Code 20560 is used for needle insertions into one or two muscles, while CPT® Code 20561 is designated for procedures involving three or more muscles.
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The procedure described by CPT® Code 20560 is indicated for the treatment of pain and restricted range of motion associated with myofascial trigger points. These trigger points are often characterized by localized muscle tightness and discomfort, which can result from various conditions, including muscle strain, overuse injuries, or chronic pain syndromes. The goal of dry needling is to relieve pain and improve function by targeting these specific areas within the muscle tissue.
The procedure for CPT® Code 20560 involves several key steps that ensure effective needle insertion into the targeted muscle tissue. First, the healthcare provider will conduct a thorough assessment of the patient's condition, identifying the specific muscles that exhibit trigger points. Once the target areas are determined, the provider will prepare the treatment area, ensuring it is clean and free from any contaminants. The next step involves the careful insertion of thin, solid-filament needles into the identified trigger points within one or two muscles. The depth and angle of insertion may vary based on the muscle's location and the provider's technique. The needles may be left in place for a duration ranging from a few seconds to 30 minutes, depending on the treatment plan and the patient's response. In some cases, electrical stimulation may be applied to the needles to enhance the therapeutic effect. After the designated time, the needles are gently removed, and the provider may offer post-procedure instructions to the patient regarding care and follow-up.
After the procedure coded under CPT® Code 20560, patients may experience some soreness in the treated muscles, which is a common response to dry needling. It is important for healthcare providers to inform patients about this potential discomfort and to provide guidance on managing it. Patients may be advised to apply ice to the treated area to reduce any swelling or soreness. Additionally, they may be encouraged to engage in gentle stretching or follow-up exercises as part of their recovery process. The provider may also schedule follow-up appointments to monitor the patient's progress and determine if additional treatments are necessary. Overall, the post-procedure care aims to enhance the benefits of dry needling and support the patient's rehabilitation journey.
| Short Descr | NDL INSJ W/O NJX 1 OR 2 MUSC | Medium Descr | NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES | Long Descr | Needle insertion(s) without injection(s); 1 or 2 muscle(s) | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| GA | Waiver of liability statement issued as required by payer policy, individual case | GP | Services delivered under an outpatient physical therapy plan of care | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KX | Requirements specified in the medical policy have been met | GX | Notice of liability issued, voluntary under payer policy | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GZ | Item or service expected to be denied as not reasonable and necessary | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CG | Policy criteria applied | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GO | Services delivered under an outpatient occupational therapy plan of care | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | RT | Right side (used to identify procedures performed on the right side of the body) | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2020-01-01 | Added | Code added. |
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