Summary & Overview
CPT 0102T: Shock Wave Treatment of Lateral Humeral Epicondyle Under Anesthesia
CPT code 0102T represents a shock wave treatment procedure applied to the lateral humeral epicondyle, performed under anesthesia other than local anesthetic. This code is classified as a Category III CPT code, signifying its use for emerging medical technologies and procedures that are not yet widely adopted or fully established in clinical practice. The procedure is typically conducted in an ambulatory surgical center, highlighting its outpatient setting and the requirement for advanced anesthesia services.
Nationally, this code is relevant for providers specializing in pain medicine, physical medicine and rehabilitation, and orthopaedic surgery of the spine. The publication covers key payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing insight into payer coverage and policy considerations for this procedure.
Readers will gain an understanding of the clinical context for 0102T, including its role in treating musculoskeletal conditions such as intervertebral disc displacement, low back pain, and sciatica. The summary also addresses related billing codes, common modifiers, and associated provider taxonomies. This resource offers benchmarks and policy updates to inform stakeholders about the evolving landscape of shock wave treatments in outpatient settings.
CPT Code Overview
CPT code 0102T describes the application of shock wave treatment to the lateral humeral epicondyle in an anesthetized patient. This procedure is performed under anesthesia other than a local anesthetic, indicating a higher level of intervention and patient management. As a Category III code, 0102T is used for emerging technologies, services, and procedures that require further clinical evidence and assessment. The typical site of service for this procedure is an Ambulatory Surgical Center (Place of Service 24), reflecting its outpatient nature and the need for specialized equipment and anesthesia support.
Clinical & Coding Specifications
Clinical Context
A patient presents with chronic lateral epicondylitis (commonly known as tennis elbow) that has not responded to conservative treatments such as physical therapy, medications, or local injections. The physician determines that shock wave therapy may be beneficial. Due to the intensity of the procedure, anesthesia other than a local anesthetic is required. The patient is scheduled for the procedure at an ambulatory surgical center. The workflow includes pre-procedure assessment, administration of anesthesia, application of shock wave treatment to the lateral humeral epicondyle, and post-procedure monitoring. The procedure is typically performed by a pain medicine physician, physical medicine & rehabilitation physician, or an orthopaedic surgery of the spine physician.
Coding Specifications
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Modifier
50(Bilateral Procedure): Used when the shock wave treatment is applied to both lateral humeral epicondyles during the same session. -
Modifier
51(Multiple Procedures): Used when the shock wave treatment is performed in conjunction with other procedures during the same operative session.
| Provider Taxonomy Code | Specialty |
|---|---|
208VP0000X |