From the Research
The CPT code for a trigger finger injection is 20550. This code specifically covers the injection of tendon sheath, ligament, or ganglion cyst. When performing a trigger finger injection, the physician injects a corticosteroid medication (such as triamcinolone or methylprednisolone) into the tendon sheath of the affected finger. The typical dose ranges from 10-40 mg of steroid medication, with a recent study 1 suggesting that a 20-mg dose may be more effective than lower doses. The procedure is performed using sterile technique, and the injection is directed into the flexor tendon sheath at the level of the A1 pulley where the triggering occurs. Documentation should include the specific digit treated, medication used with dosage, and the patient's response. This injection works by reducing inflammation in the tendon sheath, which allows the tendon to glide more smoothly through the pulley system and relieves the catching or locking sensation characteristic of trigger finger. Most patients experience relief within a few days to a week after the injection. Some studies suggest that the use of local anesthetic with the corticosteroid injection may increase pain at the time of injection 2, while others have found that splinting alone may be as effective as steroid injection alone in terms of pain reduction and functional improvement 3. However, the most recent and highest quality study on the topic of trigger finger injection dosage found that a 20-mg dose of triamcinolone acetonide was more effective than lower doses 1. It's also worth noting that low-dosage triamcinolone acetonide injections (up to 8 mg) may be effective and safe, with no significant difference in recurrence rates compared to higher doses 4. Overall, the choice of treatment for trigger finger should be based on individual patient needs and preferences, taking into account the potential benefits and risks of each option. Key points to consider when performing a trigger finger injection include:
- Using a sterile technique to minimize the risk of infection
- Directing the injection into the flexor tendon sheath at the level of the A1 pulley
- Documenting the specific digit treated, medication used with dosage, and the patient's response
- Considering the use of a 20-mg dose of triamcinolone acetonide, as suggested by recent studies 1
- Being aware of the potential for increased pain with the use of local anesthetic 2 and the effectiveness of splinting alone or in combination with steroid injection 3.