Summary & Overview
CPT 0219T: Cervical Facet Joint Spacer Implantation, Image-Guided
CPT code 0219T represents image-guided implantation of an allograft or synthetic spacer into the facet joint of the cervical vertebrae to expand and stabilize joint space and reduce pain from degenerative disease or trauma. This code captures a targeted, minimally invasive spinal intervention focused on the cervical facet complex and is relevant to payers and providers managing spine care and procedural pain management nationally. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for use of this procedure, where it is typically performed (hospital outpatient departments and ambulatory surgery centers), and how the service is classified for billing. The summary covers common billing modifiers and notes where payer-specific policies and coverage criteria commonly influence utilization and reimbursement. The publication provides benchmarks and policy updates where available, clarifies the clinical indications implicit in the code description, and outlines areas where payers frequently require additional documentation or prior authorization. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0219T describes a procedure in which the provider implants an allograft or synthetic spacer into the facet joint of the cervical vertebrae under image guidance. The intent of the procedure is to expand and stabilize the facet joint space and to lessen pain related to degenerative changes or trauma in the cervical spine.
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Service type: Image-guided cervical facet joint spacer implantation
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Typical site of service: Hospital outpatient department or ambulatory surgery center, performed under image guidance
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with chronic neck pain and radicular symptoms following progressive cervical facet arthropathy undergoes a minimally invasive cervical facet spacer implantation under fluoroscopic guidance. The patient has failed conservative measures including physical therapy, oral analgesics, and cervical epidural steroid injections. Pre-procedure workflow includes history and physical, informed consent, preoperative imaging review (cervical CT and MRI), and peri-procedural anesthesia evaluation. In the interventional suite the patient is positioned supine or prone depending on approach, sterile prep is performed, and real-time image guidance (fluoroscopy or cone-beam CT) is used to localize the target cervical facet joint. A small incision is made, and under imaging the provider implants an allograft or synthetic spacer into the facet joint to expand and stabilize the joint space. Hemostasis is achieved, dressings applied, and the patient is monitored in recovery for immediate complications before discharge with post-procedure instructions and follow-up arranged.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for 0219T due to complexity. |
23 | Unusual anesthesia | Use when general anesthesia is medically necessary for 0219T and not typical for the service. |
51 | Multiple procedures | Use when 0219T is billed in the same operative session with other unrelated procedures. |
52 | Reduced services | Use when 0219T is partially reduced or not completed but attempted. |
53 | Discontinued procedure | Use when 0219T is started but stopped for patient safety before completion. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons for 0219T. |
66 | Surgical team | Use when an organized surgical team is required for 0219T. |
78 | Return to OR for related procedure during postoperative period | Use when a return to the operating room is required for a complication related to 0219T. |
80 | Assistant surgeon | Use when an assistant surgeon performs part of the 0219T procedure. |
81 | Minimum assistant surgeon | Use when a minimum assistant surgeon is required for 0219T. |
82 | Assistant surgeon — when qualified resident not available | Use when a qualified resident is not available and an assistant is used for 0219T. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist billing | Use when an advanced practice clinician performs portion of care under state law and payer rules for 0219T. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Use when the physician directs concurrent anesthesia for 0219T. |
QX | CRNA service with medical direction by physician | Use when a CRNA provides anesthesia for 0219T under physician direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Physical Medicine & Rehabilitation Physician | Commonly performs image-guided cervical facet procedures in outpatient interventional settings. |
| 207XS0102X | Neurological Surgery | Performs surgical implantation of spinal devices including cervical facet spacers. |
| 2086S0105X | Pain Medicine Physician | Interventional pain specialists commonly perform 0219T using fluoroscopic guidance. |
| 207L00000X | Orthopedic Surgery | Spine surgeons implant spacers for cervical facet arthropathy and trauma cases. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M50.20 | Cervical disc disorder, unspecified, mid-cervical region | Cervical degenerative disease causing facet joint load and pain; may coexist with facet arthropathy treated by 0219T. |
M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region | Degenerative changes of the cervical spine that can produce facet joint degeneration addressed by the spacer implantation. |
M53.82 | Other specified dorsopathies, cervical region | General cervical spine pathology that may present with facetogenic pain amenable to 0219T. |
M54.2 | Cervicalgia | Symptom code for neck pain often used to support medical necessity for facet joint interventions like 0219T. |
M48.02 | Spinal stenosis, cervical region | Facet hypertrophy and joint degeneration contributing to foraminal or central stenosis; spacer may relieve facet-related pain. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
77002 | Fluoroscopic guidance for needle placement (spine) | Image guidance code commonly reported when fluoroscopy is used to localize the cervical facet for 0219T. |
20931 | Allograft, morselized or placement of osteopromotive material for spine surgery | May report when bone graft or allograft material is implanted as part of the spacer procedure if payer policies allow. |
22845 | Implantation of intervertebral biomechanical device, anterior column (cervical) | Related spinal implant code; used when separate intervertebral devices are implanted in same session (different device class). |
64490 | Injection, diagnostic or therapeutic, anesthetic agent; cervical or thoracic nerve root(s) | May be performed pre-procedure for diagnostic correlation or symptom control in the cervical region. |
99024 | Postoperative follow-up visit, normally included in global period | Represents routine postoperative visits occurring in global period after 0219T when billed separately per payer rules. |