CPT® Code 0102T

1. Indications

Extracorporeal shock wave therapy (ESWT) is indicated for a variety of musculoskeletal conditions, particularly those involving pain and inflammation in the tendons and surrounding tissues. The specific indications for the procedure associated with CPT® Code 0102T include:

• Plantar Fasciitis - A common cause of heel pain characterized by inflammation of the plantar fascia.
• Achilles Tendinitis - Inflammation of the Achilles tendon, often resulting in pain and stiffness.
• Patellar Tendinitis - Inflammation of the patellar tendon, commonly known as "jumper's knee," which causes pain around the kneecap.
• Tendinopathies of the Shoulder - Conditions affecting the tendons in the shoulder, leading to pain and limited mobility.
• Tendinopathies of the Elbow - Specifically, conditions affecting the lateral humeral epicondyle, commonly referred to as "tennis elbow."
• Stress Fractures - Small cracks in the bone that occur due to repetitive force or overuse.
• Delayed Healing in Union or Non-Union Fractures - Situations where fractures do not heal properly or take longer than expected to heal.
• Avascular Necrosis of the Femoral Head - A condition where blood supply to the femoral head is disrupted, leading to bone death and joint pain.

2. Procedure

The procedure for extracorporeal shock wave therapy (ESWT) as described by CPT® Code 0102T involves several key steps to ensure effective treatment of the lateral humeral epicondyle. The following procedural steps are outlined:

• Step 1: Patient Preparation - The patient is positioned comfortably, and the area of tenderness on the lateral humeral epicondyle is identified and marked while the patient is awake and alert. This ensures accurate targeting of the treatment area.
• Step 2: Anesthesia Administration - Anesthesia other than local, such as regional or general anesthesia, is administered to the patient to ensure comfort during the procedure. This step is crucial as it allows the patient to tolerate the treatment without discomfort.
• Step 3: Application of Ultrasound Gel - A highly viscous ultrasound gel is applied to the skin over the marked area. This gel serves to enhance the transmission of shock waves from the treatment head to the skin and underlying tissues.
• Step 4: Coupling the Treatment Head - A water-filled treatment head is firmly coupled to the skin over the area of interest. Proper coupling is essential to ensure effective delivery of the shock waves.
• Step 5: Delivery of Shock Waves - The shock waves are then delivered to the lateral humeral epicondyle. The treatment typically involves multiple pulses of shock waves, which work to disrupt calcium deposits, reduce inflammation, and promote healing in the affected tissues.

3. Post-Procedure

After the completion of the extracorporeal shock wave therapy (ESWT) procedure, patients may experience some mild discomfort or soreness in the treated area, which is generally temporary. It is important for patients to follow any post-procedure care instructions provided by the physician, which may include recommendations for rest, ice application, and gradual return to normal activities. Patients are typically advised to avoid strenuous activities or heavy lifting for a specified period to allow for optimal healing. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to determine if additional sessions are necessary. Overall, the expected recovery time can vary based on individual patient factors and the specific condition being treated.