CMM-200: Epidural Steroid Injections (ESI)

Covers diagnostic single-nerve selective nerve root blocks and therapeutic epidural steroid injections (transforaminal, interlaminar, caudal) for radiculopathy/radiculitis, symptomatic spinal stenosis and select synovial cysts, while excluding ultrasound- or non‑image‑guided injections, ESIs for axial pain, therapeutic repeat SNRBs, TFESIs at >2 roots or ILESIs at >1 level per session, same‑day other‑region spinal injections (with narrow exception), and injections/frequencies beyond specified limits. Key requirements include documented failure of conservative care (≥6 weeks for radiculopathy/radiculitis; ≥4 weeks for spinal stenosis), appropriate objective findings or MRI/CT (within 12 months) and/or EMG as indicated, fluoroscopic/CT guidance with contrast, strict documentation for diagnostic SNRB and repeat procedures (e.g., repeat ESI justified only if ≥2 of: ≥50% pain relief, improved function, reduced meds for ≥2 weeks), minimum intervals (≥7 days for repeat diagnostic SNRB at a different level; ≥14 days between ESIs) and limits of ≤3 ESIs per region per 6 months (≤4 per 12 months).