CMM-200: Epidural Steroid Injections
EVICORE-MSK_ADVANCED-D1EF06EE
Covers diagnostic single‑level selective nerve root blocks (anesthetic only) and therapeutic epidural steroid injections (interlaminar, caudal, transforaminal — TFESI limited to ≤2 levels per session) for radiculopathy/radicular pain or symptomatic spinal stenosis when criteria are met; excludes SNRB for non‑radicular indications (e.g., post‑herpetic neuralgia), therapeutic/repeat SNRBs, ESIs without fluoroscopic/CT guidance (or contrast), ultrasound‑guided ESIs, injectates other than anesthetic/corticosteroid/contrast (e.g., biologics), and obstetrical/surgical anesthesia. Key requirements: recent concordant neurologic exam (≤3 months) plus MRI/CT (≤24 months) or EMG/NCV, failure of ≥4 weeks conservative care for most indications, diagnostic SNRB limited to one level/side and repeat only if prior block <80% relief and ≥7 days apart, repeat ESI requires ≥50% pain relief for ≥2 weeks with functional or medication use improvement, and limits of ≤3 ESIs per region per 6 months (≤4 per 12 months).