Summary & Overview
CPT 0102T: Extracorporeal Shock Wave Therapy for Lateral Epicondyle
CPT code 0102T denotes physician-performed extracorporeal shock wave treatment targeting the lateral humeral epicondyle under anesthesia more than local, most commonly used to treat epicondylitis (tennis elbow). Nationally, this code captures a specific, anesthesia-requiring therapeutic intervention for refractory or severe cases of lateral elbow tendinopathy where in-office, local procedures are insufficient. Its correct use influences procedure grouping, site-of-service designation, and anesthesia billing.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context and service characteristics, payer coverage considerations, common procedural links, and where this code fits among related interventional spine and pain procedures. The publication summarizes benchmarks for utilization and billing relationships to associated imaging and injection codes, highlights relevant coding relationships, and outlines common clinical scenarios in which the code is used.
This summary is intended for health policy analysts, coding professionals, and clinical administrators seeking a national-level orientation to CPT code 0102T, its clinical role in managing epicondylitis, and the payer landscape that commonly adjudicates claims for this anesthesia-requiring shock wave procedure.
Billing Code Overview
CPT code 0102T describes a physician-administered extracorporeal shock wave treatment applied to the lateral humeral epicondyle of an anesthetized patient. The procedure is performed with anesthesia that is more than local (regional or general anesthesia), and is typically used to treat epicondylitis (tennis elbow), a repetitive-use injury of the elbow.
Service Type: Minimally invasive therapeutic procedure (extracorporeal shock wave therapy)
Typical Site of Service: Operating room or procedure suite with anesthesia support
Clinical & Coding Specifications
Clinical Context
A 46-year-old right-handed patient with a 9-month history of refractory lateral epicondylitis (tennis elbow) presents after failing conservative care including activity modification, nonsteroidal anti-inflammatory drugs, physical therapy, and corticosteroid injection. Imaging excludes acute fracture or advanced joint disease. The interventional pain or orthopaedic procedural workflow includes preoperative evaluation, informed consent, and anesthesia planning because the procedure requires anesthesia beyond a local block. In the operating room or ambulatory surgical center the physician performs extracorporeal shock wave or focused shock wave application to the lateral humeral epicondyle while the patient is anesthetized (general or regional). Intraoperative documentation includes indication, target site (lateral humeral epicondyle), anesthesia type and provider, laterality, energy settings and number of pulses, and immediate response. Post-procedure recovery includes monitoring in the PACU, discharge instructions for activity limitations and analgesia, and scheduled follow-up to assess pain, function, and need for further interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia | Use when general or regional anesthesia is administered for a procedure that is normally performed with local anesthesia. |
26 |