Summary & Overview

CPT 0213T: Ultrasound-Guided Cervical/Thoracic Paravertebral Facet Injection

CPT code 0213T defines an ultrasound-guided injection of a diagnostic or therapeutic agent into a single cervical or thoracic paravertebral facet joint or the exiting spinal nerve. This procedure is used to relieve neck or upper back pain or to provide anesthetic for surgical procedures. The code captures an image‑guided interventional pain management service distinct from fluoroscopic or CT-guided interventions.

Nationally, ultrasound-guided spine injections have grown as facilities and clinicians seek alternatives to ionizing radiation for targeted nerve and joint interventions. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the code, typical sites of service, and the service type. The publication outlines common billing modifiers and national payer coverage patterns where available, and it provides benchmarking context and policy considerations relevant to payers and providers. Content addresses coding specificity, clinical indications, and procedural setting expectations to help billing professionals and practice managers understand claim submission implications.

Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and service line.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0213TCPTultrasound-guided injectionpain managementspine procedureparavertebral facetdiagnostic injectiontherapeutic injectionambulatory surgery

Billing Code Overview

CPT code 0213T describes an imaging-guided injection where the provider injects a diagnostic or therapeutic agent under ultrasound guidance into a single cervical or thoracic paravertebral facet joint or the spinal nerves that exit the joint. The procedure is performed to relieve pain or to administer an anesthetic for a surgical procedure.

Service Type: Image-guided paravertebral facet joint or spinal nerve injection (diagnostic or therapeutic)

Typical Site of Service: Outpatient procedure setting or ambulatory surgical center, including pain clinics and radiology procedure suites

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with chronic, unilateral neck pain radiating to the shoulder presents to an interventional pain clinic after conservative measures (physical therapy, oral analgesics, and a prior course of medial branch blocks) provided insufficient relief. Diagnostic imaging (cervical MRI) shows multilevel facet arthropathy without myelopathy. The pain specialist discusses using an ultrasound-guided paravertebral facet joint or exiting spinal nerve injection to deliver a diagnostic anesthetic to confirm the facet joint as the pain generator and/or to provide therapeutic relief prior to considering radiofrequency ablation.

The clinical workflow: the patient completes informed consent and pre-procedure screening, vital signs and anticoagulation status are reviewed, and the procedure area is prepped. Under ultrasound guidance the provider identifies the targeted cervical or thoracic paravertebral facet joint or the adjacent spinal nerve, performs local skin anesthesia, and injects a diagnostic or therapeutic agent. Post-procedure observation includes monitoring for neurologic changes, hemodynamic stability, and discharge instructions for activity limitations and expected duration of analgesia.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the procedure required substantially greater work than typical (complex anatomy, prolonged time) with documentation supporting the increased effort.

Taxonomy Code	Specialty	Notes
207L00000X	Physical Medicine & Rehabilitation (Physiatry)	Commonly performs image-guided spinal injections for pain management.
207H00000X	Anesthesiology	Pain management anesthesiologists frequently perform diagnostic and therapeutic spinal injections.
2084P0800X	Neurology (Pain Medicine)	Neurologists with pain specialization may perform targeted spinal injections.
363A00000X	Emergency Medicine	Occasionally performs urgent image-guided spinal injections in emergent settings.
207K00000X	Orthopedic Surgery	Orthopedic spine surgeons perform facet injections as part of diagnostic/therapeutic workup.

ICD-10 Code	Description	Clinical Relevance
`M54.2`	Cervicalgia	Localized neck pain often originates from facet arthropathy and is an indication for diagnostic/therapeutic facet or paravertebral injections.
`M50.12`	Other cervical disc displacement, medium cervical region with radiculopathy	Cervical radiculopathy may prompt targeted injections to determine pain generator when radicular symptoms overlap with facet-mediated pain.
`M47.812`	Spondylosis without myelopathy, cervical region	Degenerative changes at facet joints are common and may be treated diagnostically/therapeutically with injections.
`M54.31`	Sciatica, right side	While lumbar in location, analogous radicular syndromes in thoracic/cervical regions justify targeted nerve or facet injections when anatomy and symptoms correlate.
`M54.6`	Pain in thoracic spine	Thoracic facet arthropathy or nerve-related pain can be addressed with paravertebral injections under ultrasound guidance.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64483`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level	Performed when targeted transforaminal epidural steroid delivery to the nerve root is indicated instead of or in addition to paravertebral facet/nerve injections.
`64490`	Injection(s), diagnostic or therapeutic agent, paravertebral facet (eg, medial branch) or facet joint; cervical or thoracic, single level	Closely related; alternative coding for medial branch or facet joint injections depending on technique and payer guidance.
`76000`	Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injections (without imaging supervision)	Used when fluoroscopic rather than ultrasound guidance is used for localization during the procedure.
`76942`	Ultrasound guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging guidance and monitoring	CPT for ultrasound guidance that may be reported when the injection procedure is performed under ultrasound visualization per payer rules.
`64635`	Destruction by neurolytic agent; continuous/thermal or percutaneous radiofrequency lesioning, each nerve	Performed subsequently if diagnostic injection confirms the facet joint as pain source and radiofrequency ablation is indicated for longer-term relief.

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