How To Use CPT Code 0218T

CPT 0218T describes the injection of a diagnostic or therapeutic agent into the paravertebral facet joints or the nerves that innervate those joints, under ultrasound guidance. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0218T?

CPT 0218T can be used to describe the injection of a diagnostic or therapeutic agent into the paravertebral facet joints or the nerves that supply those joints, using ultrasound guidance. This code is used when the provider administers the injection at the third level of the lumbar or sacral region, and may also administer the injection at additional levels if necessary.

2. Official Description

The official description of CPT code 0218T is: ‘Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)’. It is important to note that this code should not be reported more than once per day, and should be used in conjunction with codes 0216T and 0217T. If the injection is performed using fluoroscopy or CT, different codes should be used (64490-64495). For a bilateral procedure, report 0218T twice without appending modifier 50.

3. Procedure

1. The provider assesses the patient’s condition and determines the need for paravertebral facet joint injection.
2. Under ultrasound guidance, the provider selects the appropriate level(s) for injection, typically at the third level of the lumbar or sacral region.
3. The provider inserts a needle into the paravertebral facet joint or the nerves that innervate that joint, and administers the diagnostic or therapeutic agent.
4. If necessary, the provider may also administer the injection at additional levels, using the same ultrasound guidance.
5. The procedure is performed to relieve pain or to administer anesthetic for a surgical procedure.

4. Qualifying circumstances

Patients eligible to receive CPT 0218T services are those who require diagnostic or therapeutic injections into the paravertebral facet joints or the nerves that supply those joints. The injections are typically performed for pain relief or as an anesthetic for a surgical procedure. The provider must use ultrasound guidance for accurate placement of the needle, and the injections are typically performed at the third level of the lumbar or sacral region. It is important to note that this code should not be reported more than once per day.

5. When to use CPT code 0218T

CPT code 0218T should be used when the provider administers a diagnostic or therapeutic injection into the paravertebral facet joints or the nerves that innervate those joints, using ultrasound guidance. This code is specifically for injections performed at the third level of the lumbar or sacral region, and may include additional levels if necessary. It is important to use this code in conjunction with codes 0216T and 0217T, and to use different codes if the injection is performed using fluoroscopy or CT.

6. Documentation requirements

To support a claim for CPT 0218T, the provider must document the following information:

• Patient’s diagnosis and the need for paravertebral facet joint injection
• Specific level(s) of injection performed
• Use of ultrasound guidance for accurate needle placement
• Details of the injection procedure, including the type of agent administered
• Date and time of the procedure
• Signature of the provider performing the injection

7. Billing guidelines

When billing for CPT 0218T, ensure that the injection is performed at the third level of the lumbar or sacral region, using ultrasound guidance. It is important to use this code in conjunction with codes 0216T and 0217T, and to use different codes if the injection is performed using fluoroscopy or CT. It is also important to note that this code should not be reported more than once per day. Modifier 50 should not be appended to this code for a bilateral procedure; instead, report the code twice.

8. Historical information

CPT 0218T was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A provider administers a diagnostic injection into the paravertebral facet joints at the third level of the lumbar region, using ultrasound guidance, to determine the cause of a patient’s back pain.
2. Under ultrasound guidance, a provider performs a therapeutic injection into the nerves that innervate the paravertebral facet joints at the third and fourth levels of the sacral region, to provide pain relief for a patient with sacroiliac joint dysfunction.
3. A provider administers an anesthetic injection into the paravertebral facet joints at the third level of the lumbar region, under ultrasound guidance, to prepare a patient for a surgical procedure.
4. Using ultrasound guidance, a provider performs a diagnostic injection into the paravertebral facet joints at the third level of the sacral region, to determine the cause of a patient’s sciatica.
5. A provider administers a therapeutic injection into the nerves that innervate the paravertebral facet joints at the third level of the lumbar region, under ultrasound guidance, to provide pain relief for a patient with facet joint arthritis.
6. Under ultrasound guidance, a provider performs a diagnostic injection into the paravertebral facet joints at the third and fourth levels of the sacral region, to determine the cause of a patient’s hip and lower back pain.
7. A provider administers an anesthetic injection into the paravertebral facet joints at the third level of the lumbar region, under ultrasound guidance, to prepare a patient for a lumbar discectomy.
8. Using ultrasound guidance, a provider performs a therapeutic injection into the nerves that innervate the paravertebral facet joints at the third level of the sacral region, to provide pain relief for a patient with chronic pelvic pain.
9. A provider administers a diagnostic injection into the paravertebral facet joints at the third level of the lumbar region, under ultrasound guidance, to determine the cause of a patient’s radicular pain.
10. Under ultrasound guidance, a provider performs a therapeutic injection into the nerves that innervate the paravertebral facet joints at the third and fourth levels of the sacral region, to provide pain relief for a patient with post-surgical back pain.