Billing and Coding: Epidural Steroid Injections for Pain Management
A58993
This article provides coding and billing guidance for epidural steroid injections (ESIs) referencing LCD L39240 and applies only to epidural injections. It defines permitted uses (including cisternography, postoperative pain management, and implantable pump trials), unit and level limits (one spinal region per day, ≤2 levels per session for transforaminal codes, CPT 62321/62323 one level per session), a maximum of 4 sessions per spinal region in a rolling 12 months, specific modifier and billing rules (KX for DSNRB, 50/RT/LT for bilateral reporting), required documentation (legible signed records, imaging, pain scores), and exclusions such as non‑FDA injectants, billing epidural codes for chemotherapy, and routine reimbursement of deep sedation.
"Epidural steroid injections (epidural injections) for pain management are covered when reasonable and necessary as defined by LCD L39240."