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Trigger Point Injections (TPI): 7 Medicare contractor policies compared

7 Local Coverage Determinations in the current Medicare Coverage Database export carry the title "Trigger Point Injections (TPI)", between them covering 61 states and territories. 7 of them have a billing and coding article with a diagnosis list, ranging from 2 to 10 covered ICD-10-CM codes. 3 record a source policy it was derived from. The table below is the fastest way to see which version governs a given state and how far the versions have drifted.

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Policies with this title
7
States covered
61
Versions with a coded article
7
Revision dates
2024-03-31 to 2026-09-06

Every version by contractor

Open a version for its full policy text, contracts, codes and related NCDs. Covered codes are the count of ICD-10-CM codes in the version's billing and coding article; a dash means the export attaches no coded article.

Local Coverage Determinations titled "Trigger Point Injections (TPI)"
LCDContractorStatesRevisedCovered codesPolicy words
L33912First Coast Service Options, Inc.FL PR VI2026-09-062376
L34211Noridian Healthcare Solutions, LLCAK AS AZ CA CNMI GU HI ID MT ND NF NV OR SD SF UT WA WY2025-10-23101,021
L35010Novitas Solutions, Inc.AR CO DC DE LA MD MS NJ NM OK PA TX2026-09-062376
L39656CGS Administrators, LLCKY OH2024-04-01101,026
L39662Wellpoint FederalCT DN IL MA ME MN NH NY QN RI UN VT WI2026-04-01101,026
L39671Palmetto GBAAL GA NC SC TN VA WV2024-03-31101,034
L39713Wisconsin Physicians Service Insurance CorporationAK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NM NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY2026-01-29101,356

Lineage

The Medicare Coverage Database records the source policy a determination was derived from: L33912 from L29199; L34211 from L33498; L35010 from L27540. A shared source explains why the opening paragraphs read alike; the revision dates and the diagnosis counts above show where the versions have since parted.

How to use the comparison

Start from the state where the service is furnished and open that contractor's version; its billing and coding article carries the diagnosis codes the claims system will test. For a group that bills in several jurisdictions, the version with the smallest covered list is the safe common denominator for pre-service review, and the version with the largest list shows what documentation can support an appeal elsewhere. The L39671 version is the one most searched for this title; the LCD lookup guide explains how jurisdictions are assigned, and the LCD hub lists every topic that more than one contractor has written.

Frequently asked questions

Why are there 7 LCDs called "Trigger Point Injections (TPI)"?

Each Medicare Administrative Contractor writes its own Local Coverage Determination for its jurisdiction. 7 contractors publish a policy with this title covering 61 states; they often start from one contractor's text and then revise separately, so dates, criteria and diagnosis lists differ by jurisdiction.

Which "Trigger Point Injections (TPI)" LCD applies to my claim?

The one written by the contractor that processes the claim: the A/B MAC for the state where the service is furnished, or the DME MAC region for equipment. The table lists each policy's states; open the policy for that jurisdiction and its billing and coding article.

How different are the diagnosis lists?

Among the 7 versions with a billing and coding article, the covered ICD-10-CM list ranges from 2 to 10 codes. A diagnosis accepted under one contractor can deny under another, which is the most common cause of coverage denials for multi-state groups.

When were these policies last revised?

Revision effective dates run from 2024-03-31 to 2026-09-06. A claim is judged against the version in force on the date of service.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Policy metadata and code counts are reproduced from the CMS Medicare Coverage Database export as an operational reference. Verify against the current LCD and article on cms.gov before billing. Not legal, clinical or billing advice.