ACR Backs Ultrasound Guidance for Trigger Point Care

ACR^® supports a multispecialty effort urging Medicare contractors to cover ultrasound guidance for certain Trigger Point Injections (TPI) to improve patient safety and accuracy.

ACR joined eight medical societies to submit public comments regarding a proposed local coverage determination (LCD) from Medicare Administrative Contractors (MACs) First Coast Service Options and Novitas Solutions, Inc. The comments ask the MACs to recognize ultrasound guidance as medically appropriate when injections are performed in deep or high risk anatomical areas, such as the neck, chest wall and deep gluteal muscles. The proposed LCD deems ultrasound guidance for TPI “investigational,” but imaging is critical for safe and accurate care.

The medical societies emphasized that ultrasound guidance helps clinicians avoid neurovascular structures, reduce complications and confirm accurate needle placement, especially in complex anatomy or patients with higher body mass index. Multisociety clinical guidelines published in 2024 support the selective use of ultrasound in these settings.

ACR previously commented on this clinical area. The College partnered with medical societies in October 2024 to submit evidence to five other MACs during their review of TPI.

ACR’s Contractor Advisory Committee Network monitors all LCDs relevant to radiology, and in most instances, each clinical topic is reviewed annually for potential updates to coding or coverage criteria.

ACR will continue to collaborate with partner societies and MACs to promote evidence-based policies that ensure safe, effective care for Medicare beneficiaries.

For more information or if you have questions, contact Alicia Blakey, ACR Manager of Economic Policy.