CPT® Code 64470

Deleted

Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level

A paravertebral facet joint or facet joint nerve injection involves the administration of an anesthetic agent and/or steroid into the facet joint or its associated nerve. Facet joints are small joints located at the back (posterior) of the spine, situated on either side of the vertebrae where one vertebra overlaps another. These joints play a crucial role in providing stability and facilitating movement in the spine. Pain originating from these joints can arise from various conditions, including post laminectomy syndrome, which may occur after spinal surgery due to destabilization of the spinal joints, formation of scar tissue, or recurrent disc herniation. Other potential causes of facet joint pain include spondylosis, a degenerative condition affecting the spine, spondylolisthesis, where a vertebra slips out of place, and arthritis, which can lead to inflammation and pain in the joints. During the procedure, fluoroscopic guidance may be utilized to ensure accurate placement of the injection. Initially, the skin over the facet joint is prepared, and a local anesthetic is administered to minimize discomfort. A spinal needle is then carefully directed into the facet joint space until it encounters bone or cartilage. To confirm correct needle positioning, a small amount of contrast material is injected. Following this verification, a local anesthetic and/or steroid is injected into the joint. The diagnostic facet joint injection primarily uses a local anesthetic to help identify the specific area responsible for the patient's pain. If the patient experiences significant pain relief after this diagnostic injection, a therapeutic injection may be performed on a subsequent date, utilizing a long-acting local anesthetic combined with a steroid for more prolonged relief. For coding purposes, CPT® Code 64470 is used for a single cervical or thoracic facet joint injection, while 64472 is designated for each additional cervical or thoracic level injected. Similarly, 64475 is used for a single lumbar or sacral facet joint injection, with 64476 for each additional lumbar or sacral level injected.