2025 CPT code 20561
Effective Date: N/A Surgery - Musculoskeletal System Feed
Needle insertion(s) without injection into 3 or more muscles.
Modifiers may be applicable in certain situations, such as reduced services (modifier 52), discontinued procedures (modifier 53), or distinct procedural service (modifier 59). Refer to current CPT guidelines and payer policies for appropriate modifier usage.
Medical necessity for dry needling must be established by documenting the presence of myofascial pain, trigger points, and functional limitations. The documentation should clearly link the dry needling procedure to the patient's condition and demonstrate how it is expected to improve their symptoms and function.
Typically performed by physical therapists with specialized training in dry needling. After sterilizing the area, the therapist inserts thin, disposable needles into the trigger points of the specified muscles. The needles are then removed and discarded.
In simple words: The provider inserts thin needles into tight, painful spots in three or more of your muscles. No medication is injected. This helps relieve muscle pain and improve movement. It is different from acupuncture.
This code refers to the insertion of needles, without injecting any substance, into three or more muscles. It is often used to treat myofascial pain by targeting trigger points, which are tight, tender areas within muscles. The procedure aims to release muscle tension, reduce pain, and improve range of motion. It's important to note that dry needling is distinct from acupuncture, which is based on traditional Chinese medicine principles.
Example 1: A patient presents with chronic lower back pain due to multiple trigger points in the lumbar paraspinal muscles. The physical therapist performs dry needling on three or more affected muscles to alleviate pain and restore function., A patient experiences shoulder pain and limited range of motion due to trigger points in the trapezius, infraspinatus, and supraspinatus muscles. Dry needling is used to target these muscles and improve mobility., A patient with fibromyalgia has widespread muscle pain and tenderness. Dry needling is performed on multiple trigger points throughout the body to provide pain relief.
Documentation should include the location and number of muscles treated, the patient's response to the procedure, and any complications encountered. Supporting documentation, such as physical exam findings and prior treatment history, should also be included.
** Dry needling is a relatively new procedure and coverage policies may vary among payers. It is essential to verify coverage with the patient's insurance provider prior to performing the procedure.
- Specialties:Physical Therapy, Pain Management, Sports Medicine
- Place of Service:Office, Outpatient Hospital, Physical Therapy Clinic