Billing and Coding: Epidural Steroid Injections for Pain Management

This article provides billing and coding guidance for epidural steroid injections for pain management per LCD L39054, defining applicable CPT codes, anatomic spinal regions, and specific reporting conventions (e.g., unilateral vs bilateral billing and ASC requirements). It limits treatments to one spinal region per session, level-specific limits (1–2 levels depending on CPT), a maximum of four sessions per spinal region in a rolling 12 months, and requires complete, signed, and supportive documentation; use of non–FDA-approved injectants and routine deep sedation are not covered and may result in claim denial.

"Epidural steroid injections (epidural injections) are covered for pain management when reasonable and necessary per LCD L39054."

Sign up to see full coverage criteria, indications, and limitations.