Summary & Overview
CPT 0215T: Ultrasound-Guided Cervical/Thoracic Paravertebral Facet Joint Injection
CPT code 0215T identifies ultrasound-guided injection of a diagnostic or therapeutic agent into one or more additional cervical or thoracic paravertebral facet joints or the nerves that exit those joints. This procedure is used to diagnose or treat axial and radicular pain and to provide regional anesthesia for surgical procedures. As a specialized, image-guided intervention, the code captures care that often involves provider-level procedural skill and facility resources.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and billing considerations tied to this service. The publication highlights national relevance given the frequency of cervical and thoracic spine pain, the increasing use of ultrasound guidance for targeted injections, and payer coverage patterns that affect access and utilization.
This report summarizes benchmarks and coding guidance where available, explains common clinical indications and service settings, and outlines elements that typically appear on the claim. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 0215T describes the injection of a diagnostic or therapeutic agent under ultrasound guidance into one or more additional cervical or thoracic paravertebral facet joints or the nerves that exit those joints. The service is performed to relieve pain or to administer an anesthetic for a surgical procedure.
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Service type: Image-guided paravertebral facet joint or nerve injection (diagnostic or therapeutic)
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Typical site of service: Ambulatory surgical center, hospital outpatient department, or office-based procedure suite where ultrasound guidance and procedural monitoring are available.
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with chronic cervical radicular pain after a motor vehicle collision presents to an outpatient interventional pain clinic. Conservative measures including physical therapy, oral analgesics, and epidural steroid injection provided incomplete relief. The pain specialist recommends an ultrasound-guided diagnostic/therapeutic paravertebral facet joint or medial branch injection of anesthetic and steroid at additional cervical or thoracic levels to confirm the pain generator and provide symptom relief prior to proceeding with radiofrequency ablation or surgical planning. The patient arrives fasting, consents for procedure, and the provider reviews imaging and coagulation status. Under sterile conditions in an outpatient procedure suite or ambulatory surgery center, the provider uses ultrasound to identify the target paravertebral facets or exiting nerve roots, injects local anesthetic with or without steroid, monitors the patient post-procedure for recovery and documents level(s) treated, volumes and agents used, ultrasound guidance, and any immediate complications. Typical site of service is an outpatient interventional pain clinic, ambulatory surgery center, or hospital outpatient department. Typical service type is an image-guided therapeutic and diagnostic paravertebral facet or medial branch injection under ultrasound guidance to relieve pain or provide anesthetic for a subsequent surgical procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no special circumstance modifier applies |
22 | Increased procedural services | Use when documented work or complexity substantially exceeds typical for 0215T |
23 | Unusual anesthesia | Use when general anesthesia is required for the procedure and is not normally used |
50 | Bilateral procedure | Use when identical injections are performed bilaterally during the same session |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally intended |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to patient safety or other complications |
62 | Two surgeons | Use when two surgeons work together as primary surgeons on the procedure |
66 | Surgical team | Use when a surgical team other than the primary surgeon performs the procedure |
78 | Unplanned return to OR/procedure | Use when patient requires an unplanned return to the procedure room for related care |
80 | Assistant surgeon | Use when an assistant surgeon participates in the procedure |
81 | Minimum assistant surgeon | Use when a minimum assistant participates per payer policy |
82 | Assistant (when qualified assistant surgeon not available) | Use when an assistant performs duties because a qualified assistant is unavailable |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist service | Use to identify services furnished by a physician assistant, nurse practitioner, or clinical nurse specialist where applicable |
QK | Medical direction of 2-4 concurrent anesthesia procedures | Use when the provider medically directs multiple concurrent anesthesia procedures required for the case |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Pain Medicine | Interventional pain specialists who perform diagnostic and therapeutic facet injections |
| 2084P0800X | Physical Medicine & Rehabilitation | PM&R physicians who perform image-guided spinal injections |
| 207L00000X | Anesthesiology | Anesthesiologists who perform or supervise ultrasound-guided spinal procedures |
| 363A00000X | Physician Assistant | Physician assistants who may assist or perform injections under supervision |
| 363L00000X | Nurse Practitioner | Nurse practitioners credentialed to perform or assist with image-guided injections |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M54.12 | Radiculopathy, cervical region | Common indication when cervical paravertebral facet or nerve injections are used for diagnostic or therapeutic purposes |
M54.2 | Cervicalgia | Localized neck pain that may be managed with facet or medial branch injections |
M54.16 | Radiculopathy, thoracic region | Thoracic radicular pain amenable to thoracic paravertebral injections |
M54.6 | Pain in thoracic spine | Focal thoracic spinal pain where targeted injections may provide relief |
M48.02 | Spinal stenosis, cervical region | Symptomatic stenosis with facet-mediated pain components treated diagnostically or therapeutically with injections |
M47.12 | Spondylosis with myelopathy, cervical region | Degenerative cervical spine disease where targeted injections can identify pain sources prior to further intervention |
G54.1 | Brachial plexus and root disorders | When nerve-root related pain of cervical origin is present and diagnostic injections are indicated |
R52 | Pain, unspecified | Use when the precise spine-related diagnosis is not otherwise specified but intervention is clinically justified |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
20552 | Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | May be performed adjunctively for myofascial components of neck or thoracic pain in the same encounter |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder) | Not directly the same region but represents comparable injection/documentation workflow when performed during the visit |
64483 | Injection(s), diagnostic or therapeutic agent, anesthetic/saline and/or steroid, spinal nerve root; lumbar or sacral, single level | Analogous spinal nerve root injection code for other regions; useful for cross-referencing technique and documentation standards |
64633 | Destruction by neurolytic agent; neurolytic agent, paravertebral facet joint nerves (e.g., medial branch), cervical or thoracic, single level | Often follows diagnostic/therapeutic injections when planning for neurotomy or radiofrequency ablation |
64635 | Destruction by neurolytic agent; neurolytic agent, paravertebral facet joint nerves, lumbar, single level | Related ablative procedure for confirmed facet-mediated pain; included for workflow context |
77002 | Fluoroscopy, guidance for needle placement (e.g., diagnostic or therapeutic injection procedures) | If fluoroscopic rather than ultrasound guidance is used, this imaging guidance code documents the imaging assistance provided |