Overview of CPT Code 20956: Injection, facet joint, lumbar or sacral
CPT Code 20956 refers to the injection of a facet joint in the lumbar or sacral region, primarily used to alleviate pain and inflammation associated with spinal conditions.
When CPT Code 20956 is Used?
This procedure is indicated in various clinical scenarios.
- Chronic lower back pain due to facet joint arthritis.
- Pain radiating from the lumbar spine to the lower extremities.
- Failed conservative treatment for lumbar facet joint pain.
- Post-surgical pain management in patients with lumbar spine surgery.
Symptoms Indicating This Procedure
Patients typically report specific symptoms that may warrant this injection.
- Localized pain in the lower back.
- Pain that worsens with certain movements or positions.
- Stiffness in the lumbar region.
- Radiating pain into the buttocks or thighs.
Causes and Risk Factors
Understanding the underlying causes can help in managing the condition.
- Degenerative disc disease.
- Osteoarthritis of the spine.
- Previous spinal injuries.
- Age-related changes in spinal structure.
Diagnostic Tests Before Procedure
Certain tests are essential to confirm the need for this injection.
- MRI of the lumbar spine to assess facet joint pathology.
- X-rays to evaluate spinal alignment and degeneration.
- CT scans for detailed imaging of the facet joints.
- Nerve conduction studies if nerve involvement is suspected.
Procedure Description
The injection procedure involves several key steps.
- Patient is positioned comfortably, usually lying face down.
- Skin is cleaned and sterilized at the injection site.
- Local anesthetic may be administered to minimize discomfort.
- A needle is carefully inserted into the facet joint under fluoroscopic guidance.
- A mixture of corticosteroid and anesthetic is injected into the joint.
- Needle is removed, and a bandage is applied to the site.
Preparation for the Procedure
Patients should follow specific guidelines before the injection.
- Avoid blood thinners for a few days prior to the procedure.
- Inform the physician of any allergies, especially to medications.
- Arrive at the facility with a responsible adult for post-procedure transport.
- Wear comfortable clothing that allows easy access to the lower back.
Recovery and Aftercare
Post-procedure care is crucial for optimal recovery.
- Rest for the remainder of the day after the injection.
- Apply ice to the injection site to reduce swelling.
- Avoid strenuous activities for at least 48 hours.
- Follow up with the physician to assess pain relief and any side effects.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Infection at the injection site.
- Bleeding or hematoma formation.
- Nerve damage or irritation.
- Temporary increase in pain after the injection.
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Post-Procedure Follow-Up
Monitoring after the procedure is essential.
- Schedule a follow-up appointment within 1-2 weeks.
- Report any unusual symptoms or complications immediately.
- Assess pain relief and functional improvement during follow-up.
Alternative Treatments
There are several non-surgical options available.
- Physical therapy to strengthen back muscles.
- Chiropractic adjustments.
- Acupuncture for pain relief.
- Medications such as NSAIDs or muscle relaxants.
Home Care Tips
Patients can take simple steps to aid recovery at home.
- Maintain a healthy posture while sitting and standing.
- Engage in gentle stretching exercises as advised by a therapist.
- Stay hydrated and maintain a balanced diet.
- Use heat therapy for muscle relaxation if recommended.
Patient Education & Prevention
Educating patients can help prevent recurrence.
- Understand the importance of maintaining a healthy weight.
- Incorporate regular exercise to strengthen the back.
- Avoid heavy lifting and twisting motions.
- Seek early intervention for back pain to prevent chronic issues.
Billing and Coding Information
CPT Code: 20956
Category: Injection Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $500 to $1,500 per injection.
- Many insurance plans cover this procedure with prior authorization.
- Out-of-pocket costs depend on the patient's deductible and copay.
Related CPT Codes
- 20610 - 'Arthrocentesis, aspiration of joint'
- 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
References and Sources
Frequently Asked Questions (FAQs)
What should I expect during the injection?
You may feel a brief pinch or pressure at the injection site.
How long does the pain relief last?
Pain relief can last from a few days to several months.
Are there any restrictions after the procedure?
Avoid heavy lifting and strenuous activities for a few days.
Can I drive after the injection?
It is advisable to have someone drive you home after the procedure.
