Overview of CPT Code 20938: Injection of anesthetic agent into facet joint
CPT Code 20938 refers to the injection of an anesthetic agent into a facet joint, which is a small joint in the spine that helps provide stability and flexibility. This procedure is often performed to relieve pain associated with conditions affecting the spine.
When CPT Code 20938 is Used?
This procedure is indicated in various clinical scenarios.
- Chronic back pain due to facet joint arthritis.
- Pain following spinal surgery.
- Pain from spinal injuries affecting the facet joints.
- Diagnostic purposes to confirm the source of pain.
Symptoms Indicating This Procedure
Patients may report specific symptoms that lead to this procedure.
- Localized pain in the lower back or neck.
- Pain that worsens with certain movements.
- Stiffness in the back.
- Radiating pain to the legs or arms.
Causes and Risk Factors
Several factors can contribute to the need for this procedure.
- Degenerative disc disease.
- Osteoarthritis of the spine.
- Previous spinal injuries.
- Age-related changes in the spine.
Diagnostic Tests Before Procedure
Certain tests may be conducted to guide the procedure.
- MRI or CT scans to visualize the spine.
- X-rays to assess joint alignment.
- Nerve conduction studies to evaluate nerve function.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, often lying face down.
- Skin is cleaned and sterilized at the injection site.
- Local anesthetic may be applied to minimize discomfort.
- A needle is carefully inserted into the facet joint under imaging guidance.
- An anesthetic agent is injected into the joint space.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Avoid blood thinners for a few days prior to the procedure.
- Inform the doctor of any allergies or medications.
- Arrange for transportation home post-procedure.
Recovery and Aftercare
Post-procedure care is essential for recovery.
- Rest for the first 24 hours after the injection.
- Apply ice to the injection site to reduce swelling.
- Follow up with the physician as directed.
Possible Complications
While generally safe, there are potential risks.
- Infection at the injection site.
- Bleeding or bruising.
- Nerve damage or increased pain.
- Allergic reaction to the anesthetic agent.
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Post-Procedure Follow-Up
Monitoring after the procedure is important.
- Follow-up appointment within 1-2 weeks.
- Monitor pain levels and functional improvement.
- Report any unusual symptoms to the physician.
Alternative Treatments
Other management options may be considered.
- Physical therapy to strengthen back muscles.
- Chiropractic adjustments.
- Medications such as NSAIDs or muscle relaxants.
- Corticosteroid injections.
Home Care Tips
Patients can take steps to aid recovery at home.
- Stay hydrated and maintain a balanced diet.
- Engage in gentle stretching exercises as tolerated.
- Avoid heavy lifting or strenuous activities.
Patient Education & Prevention
Education is key to preventing recurrence.
- Maintain a healthy weight to reduce spinal stress.
- Practice good posture while sitting and standing.
- Engage in regular low-impact exercise.
Billing and Coding Information
CPT Code: 20938
Category: Surgical Procedures
Common Modifiers:
- 50 (bilateral procedure)
- RT (right side)
- LT (left side)
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $500 to $1,500.
- Most insurance plans cover the procedure if deemed medically necessary.
Related CPT Codes
References and Sources
Frequently Asked Questions (FAQs)
What is a facet joint injection?
It is an injection of anesthetic into the facet joint to relieve pain.
How long does the procedure take?
The procedure typically takes about 30 minutes.
Will I feel pain during the injection?
You may feel some discomfort, but local anesthesia is used to minimize pain.
How soon can I return to normal activities?
Most patients can resume normal activities within a day or two.
