CPT® Code 0214T

Add-On Code

1. Indications

The procedure described by CPT® Code 0214T is indicated for patients experiencing pain associated with the paravertebral facet joints, which may arise from various underlying conditions. The following are explicitly provided indications for this procedure:

• Post-Laminectomy Syndrome Pain that occurs following spinal surgery, often due to destabilization of the spinal joints or scar tissue formation.
• Recurrent Disc Herniation Pain resulting from the reoccurrence of a herniated disc that may affect the facet joints.
• Spondylosis Degenerative changes in the spine that can lead to pain in the facet joints.
• Spondylolisthesis A condition where one vertebra slips over another, potentially causing facet joint pain.
• Arthritis Inflammation of the facet joints that can lead to chronic pain and discomfort.

2. Procedure

The procedure for CPT® Code 0214T involves several critical steps to ensure accurate delivery of the diagnostic or therapeutic agent into the paravertebral facet joint. The following procedural steps are outlined:

• Step 1: Preparation of the Skin The skin over the targeted facet joint is thoroughly cleaned and prepared to minimize the risk of infection. This step is crucial for maintaining a sterile environment during the injection process.
• Step 2: Administration of Local Anesthetic A local anesthetic is injected into the skin and surrounding tissues to reduce discomfort during the procedure. This step is essential for patient comfort and cooperation.
• Step 3: Needle Insertion A spinal needle is carefully directed into the facet joint space. The physician advances the needle until it encounters bone or cartilage, which indicates that the needle is in the correct position within the joint.
• Step 4: Contrast Material Injection A small amount of contrast material is injected through the needle to confirm its proper placement within the facet joint. This step is vital for ensuring that the injection is delivered accurately to the intended site.
• Step 5: Injection of Therapeutic Agent Following confirmation of the needle's position, a local anesthetic and/or steroid is injected into the facet joint. This injection aims to provide pain relief and may be used diagnostically to identify the source of pain.

3. Post-Procedure

After the procedure, patients may be monitored for a short period to assess their response to the injection and to ensure there are no immediate complications. It is common for patients to experience some soreness at the injection site, which typically resolves within a few days. Patients may be advised to avoid strenuous activities for a short period following the injection to allow for optimal recovery. If the diagnostic injection provides significant pain relief, a therapeutic injection may be scheduled for a later date, utilizing a long-acting local anesthetic in conjunction with a steroid to enhance pain management.