© Copyright 2025 American Medical Association. All rights reserved.
CPT® Code 20561 refers to the procedure of needle insertion(s) without injection(s) into three or more 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 developed knots, leading to discomfort and stiffness. During the procedure, fine, solid-filament needles are inserted 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 duration, ranging from a few seconds to up to 30 minutes, and can be inserted at varying depths, including subfascial or more superficially through the skin, depending on the therapeutic approach. 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 techniques differ significantly. Dry needling is often integrated into a broader treatment plan that may also encompass exercise, manual therapy, and heat therapy, enhancing the overall effectiveness of the pain management strategy.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 20561 is indicated for the treatment of various conditions associated with myofascial pain syndrome. The following are specific indications for performing needle insertion(s) into three or more muscles:
The procedure for CPT® Code 20561 involves several key steps that ensure effective treatment of the targeted muscle areas. The following outlines the procedural steps:
After the procedure associated with CPT® Code 20561, patients may experience immediate relief from pain and improved range of motion. It is common for some patients to feel soreness in the treated areas, similar to post-exercise discomfort, which typically resolves within a few days. Healthcare providers may recommend specific post-procedure care instructions, including gentle stretching, hydration, and the application of heat or ice to manage any residual soreness. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to determine if additional sessions are necessary to achieve optimal results.
| Short Descr | NDL INSJ W/O NJX 3+ MUSC | Medium Descr | NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES | Long Descr | Needle insertion(s) without injection(s); 3 or more muscles | 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 |
| GP | Services delivered under an outpatient physical therapy plan of care | GA | Waiver of liability statement issued as required by payer policy, individual case | KX | Requirements specified in the medical policy have been met | 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 | 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. | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | LT | Left side (used to identify procedures performed on the left side of the body) | GW | Service not related to the hospice patient's terminal condition | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 32 | Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure. | 33 | Preventive services: when the primary purpose of the service is the delivery of an evidence based service in accordance with a us preventive services task force a or b rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. for separately reported services specifically identified as preventive, the modifier should not be used. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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. | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | CR | Catastrophe/disaster related | G2 | Most recent urr reading of 60 to 64.9 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital | GO | Services delivered under an outpatient occupational therapy plan of care | JZ | Zero drug amount discarded/not administered to any patient | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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