LCD Reference Article Article

Traumeel Injections

A52537

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

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Article Information

General Information

Source Article ID
N/A
Article ID
A52537
Original ICD-9 Article ID
Not Applicable
Article Title
Traumeel Injections
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
01/04/2024
Revision Ending Date
N/A
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2023, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

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Article Guidance

Article Text

CGS has determined that the injection of Traumeel, a homeopathic formulation, into the soft tissues, ligaments or other structures of the foot or ankle is not medically necessary. There are no published studies on Traumeel injections in humans in the peer-reviewed literature.

  • CPT codes 20550-20553 will be denied if the material injected is determined to be Traumeel.
  • HCPCS code J3490 will be denied when used to denote Traumeel.

Response To Comments

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Coding Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
01/04/2024 R10

Revision Effective: 01/04/2024
Revision Explanation: Annual review, no changes.

11/16/2023 R9

Revision Effective: 11/16/2023
Revision Explanation: Updated LCD Reference Article section.

01/05/2023 R8

Revision Effective: 01/05/2023
Revision Explanation: Annual review no changes were made.

01/06/2022 R7

Revision Effective: 01/06/2022
Revision Explanation: Annual review no changes were made.

12/24/2020 R6

Revision Effective: N/A
Revision Explanation: Annual review no changes made.

12/26/2019 R5

Revision Effective: N/A
Revision Explanation: Annual review no changes made.

10/01/2015 R4

Revision Effective: N/A
Revision Explanation: Annual review no changes made.

10/01/2015 R3

Revision Effective: N/A

Revision Explanation: Annual review no changes made.

10/01/2015 R2 Revision Effective: N/A
Revision Explanation: Annual review no changes made.
10/01/2015 R1 R1
Revision Effective: N/A
Revision Explanation: Annual review no changes made.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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SAD Process URL 2
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Public Versions
Updated On Effective Dates Status
12/29/2023 01/04/2024 - N/A Currently in Effect You are here
11/07/2023 11/16/2023 - 01/03/2024 Superseded View
12/28/2022 01/05/2023 - 11/15/2023 Superseded View
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