Procedures
| Procedure | Alternative procedure name | Code |
| Facet joint injection(s) +/- Image Guidance (including Bilateral) CERVICAL 3 Levels per code Bupa Use: A5761 | Medial branch block, Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular block, Facet joint extra-articular block, Facet injection, Facetal blocks, Facetal injections | A5773 |
| Facet joint injection(s) +/- Image Guidance (including Bilateral) THORACIC 3 Levels per code Bupa Use: A5761 | Medial branch block, Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular block, Facet joint extra-articular block, Facet injection, Facetal blocks, Facetal injections | A5774 |
| Facet joint injection(s) +/- Image Guidance (including Bilateral) LUMBAR 3 Levels per code Bupa Use: A5761 | Medial branch block, Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular block, Facet joint extra-articular block, Facet injection, Facetal blocks, Facetal injections | A5775 |
| Paravertebral block up to two levels (without X-ray control) | Paravertebral injection | 25010 |
| 1x Injection(s) +/- aspiration, into joint, cyst, bursa with image guidance, (SIJ) or costochondrals: | Intra-articular block, Intra-articular injection, Joint block ,Joint injection | W9030 |
| • trochanteric bursae inj | ||
| • finger joints | ||
| • utrasound guided drainage of Bakers Cyst | ||
| • intraarticular and periarticular TMJ | ||
| • intraarticular injection with Cortisone | ||
| 2+ Injection(s) +/- aspiration, into two or more joints cysts, bursae with image guidance | W9035 | |
| Injection of viscosupplement into joint (one side only) | Viscosupplement, Visco, Synvisc, Synvisc One, Ostenil, Hyalgan , Hyaluronic acid, Orthovisc | W9032 |
| Injections of viscosupplement into joints – bilateral | Viscosupplement , Visco, Synvisc, Synvisc One, Ostenil, Hyalgan, Hyaluronic acid, Orthovisc | W9033 |
| Sacroiliac joint injections – Inc Bilateral | Sacroiliac joint block, SIJ injection, SIJ block | A5790 |
| Nerve Root Block +/- Image Guidance (including Bilateral) CERVICAL • Occipital nerve |
Nerve root injection, NRI, Dorsal root ganglion injection, Dorsal root ganglion block, DRG injection, DRG block | A5753 |
| Nerve Root Block +/- Image Guidance (including Bilateral) THORACIC | Nerve root injection, NRI, Dorsal root ganglion injection, Dorsal root ganglion block, DRG injection, DRG block | A5754 |
| Nerve Root Block +/- Image Guidance (including Bilateral) LUMBAR • Ilioinguinal nerve • Iliohypogastric nerve |
Nerve root injection, NRI, Dorsal root ganglion injection, Dorsal root ganglion block, DRG injection, DRG block | A5755 |
| Nerve Root Block +/- Image Guidance (including Bilateral) CAUDAL • Pudendal nerve • Ganglion of Impar • Genitofemoral nerves |
Nerve root injection, NRI, Dorsal root ganglion injection, Dorsal root ganglion block, DRG injection, DRG block | A5756 |
| Dorsal root ganglion block /nerve root injection | Nerve root injection, NRI, Dorsal root ganglion injection, Dorsal root ganglion block, DRG injection, DRG block | 25120 |
| Stellate ganglion – nerve block (LA) | Stellate injection, Stellate | 25022 |
| Nerve Block of major nerve incl • Intercostal nerve injections • Rectus sheath block • Suprascapular |
Nerve injection, Nerve block | A7352 |
| Nerve Block as a sole procedure | Nerve injection, Nerve block | A7302 |
| Epidural injection (lumbar) | Epidural, Epi | A5210 |
| Epidural injection (caudal) | Caudal, Caudal epidural, Caudal epi, Caudal injection, Caudal block | A5211 |
| Epidural injection (thoracic) | Thoracic epidural, Thoracic injection, Thoracic epi | A5220 |
| Epidural (cervical) | Cervical epidural, Cervical injection, Cervical epi | A5200 |
| Presacral sympathectomy – diagnostic (includes Coccyx infiltration) | Sympathectomy | A7682 |
| Intramuscular injection (e.g.: piriformis block) |
IM injection, IM block | X3770 |
| Trigger point injections | Trigger points, Tender points, Myofacial injections, Myofacial blocks | T7292 |
| Botulinum Toxin A injection to muscles | Botox, Botulinum Toxin A, Dysport, Myobloc, Jeuveau, Neurotoxin, Xeomin, Onanbotulinum toxin A | X3750 |
| • Piriformis muscle | ||
| • Trapezius muscle | ||
| • Lattissiums dorsi muscle | ||
| • Lumbar paravertebral muscles | ||
| • Bilateral adductor muscle & abductor muscle | ||
| Medial branch block injection(s) +/- image guidance (including bilateral) CERVICAL (injections into medial nerves b/w the facet joints) |
Medial branch block, Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular bloc, Facet joint extra-articular block, Facet injection, Facetal blocks Facetal injections | A5743 |
| Medial branch block injection(s) +/- image guidance (including bilateral) THORACIC (injections into medial nerves b/w the facet joints) |
Medial branch block , Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular block, Facet joint extra-articular block, Facet injection, Facetal blocks, Facetal injections | A5744 |
| Medial branch block injection(s) +/- image guidance (including bilateral) LUMBAR (injections into medial nerves b/w the facet joints) |
Medial branch block, Medial branch injection, Facet joint block, Facet block, Facet joint intra-articular block, Facet joint extra-articular block, Facet injection, Facetal blocks, Facetal injections | A5745 |
| Lidocaine/Ketamine IV Infusions | Lidocaine infusion, Ketamine infusion | X3590 |
| Epiduroplasty Procedures (RACZ catheter or equivalent) | Racz catheter, Racz procedure, Racz injection | A5240 |
| PRP (Platelet Rich Plasma) injections | PRP | T7481 |
| Autologous blood injections with/without dry needling (fenestrations) | Autologous blood | T7481 |
| RADIOFREQUENCY AND PENS | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation, PENS | |
| Neurolytic Root Block (Radiofrequency denervation, Thermocoagulation, Cryotherapy or Phenol, including Rhizolysis) +/- Image Guidance (including Bilateral) CAUDAL | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5766 |
| Neurolytic Root Block (Radiofrequency denervation, Thermocoagulation, Cryotherapy or Phenol, including Rhizolysis) +/- Image Guidance (including Bilateral) LUMBAR | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5765 |
| Neurolytic Root Block (Radiofrequency denervation, Thermocoagulation, Cryotherapy or Phenol, including Rhizolysis) +/- Image Guidance (including Bilateral) CERVICAL | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5763 |
| Neurolytic Root Block (Radiofrequency denervation, Thermocoagulation, Cryotherapy or Phenol, including Rhizolysis) +/- Image Guidance (including Bilateral) THORACIC | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5764 |
| Facet joint/ sacroiliac (RF) thermocoagulation including rhizolysis (under XRC) 4-6 joints – Code Inactive with CCSD | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5730 |
| Facet joint/sacroiliac (RF) thermocoagulation including rhizolysis (under XRC) up to 3 joints only – Code Inactive with CCSD | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A5720 |
| Radiofrequency (including pulsed denervation), cryoprobe or phenol for permanent lesion of named peripheral nerve +/- image guidance | Radiofrequency, Pulsed radiofrequency Radiofrequency denervation | A7300 |
| spinal discs | ||
| occipital nerve | ||
| pudendal nerve | ||
| ganglion of impar | ||
| ganglion of impar | ||
| iliohypogastric nerve | ||
| genitofemoral nerves | ||
| nerve roots e.g. L4 or L5 (BUT only one!) | ||
| Dorsal root ganglion block (radiofrequency) | DRG injections, DRG blocks | 25130 |
| Peripheral Electrical Nerve Stimulator | PENS | A6810 |
| Lumbar sympathectomy diagnostic (LA under XRC) |
Sympathectomy | A7500 |
| Lumbar sympathectomy therapeutic (neurolytic under XRC) |
Sympathectomy | A7600 |
| PENS treatment (Peripheral Electrical Nerve Stimulation) | PENS | A6810 |