Facet Joint Interventions for Pain Management

Facet joint interventions (diagnostic blocks, therapeutic injections, RFA, and facet cyst aspiration) are covered for chronic axial cervical/thoracic or lumbar/sacral pain when pain is ≥3 months, moderate-to-severe with functional deficit, has failed conservative care, and no alternative non-facet pathology explains symptoms. Diagnostic confirmation requires dual blocks with ≥80% relief, therapeutic procedures require diagnostic confirmation and demonstrate ≥50% relief (or functional improvement) for specified durations; imaging guidance (fluoroscopy or CT), provider credentialing, documentation of pain/disability scales, and specified frequency limits apply.

"Facet joint interventions are covered for chronic axial cervical/thoracic or low back pain that is moderate to severe, predominantly axial, causes functional deficit, and meets all other policy cri..."

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