CMM-200: Epidural Steroid Injections (ESI)

Covers single-level diagnostic selective nerve root blocks for specified diagnostic-uncertainty scenarios and therapeutic epidural steroid injections (transforaminal, interlaminar, caudal) for radiculopathy/radiculitis, selected synovial-cyst nerve compression, and as an initial trial for severe spinal stenosis; excludes ESIs for axial pain, therapeutic SNRBs, ultrasound-guided or non–imaging-guided ESIs, and procedures that exceed specified level or frequency limits. Key requirements include documented objective neurologic findings and concordant MRI/CT or EMG within required timeframes, failure of conservative treatment (generally ≥6 weeks for radiculopathy/radiculitis, ≥4 weeks for spinal stenosis), fluoroscopic/CT guidance with contrast, limits of ≤3 ESIs per episode (≤4 per region/year) with ≥7 days between injections, transforaminal ≤2 levels (interlaminar single level), and repeat ESI must show ≥2 specified clinical improvements for ≥2 weeks.

"Diagnostic SNRB for the purposes of surgical planning."