Facet Joint Interventions for Pain Management

Facet joint interventions (diagnostic IA/MBB, therapeutic IA/MBB, RFA, and cyst aspiration) are covered for patients with chronic (≥3 months) moderate-to-severe axial neck or low back pain who have failed conservative care, have no non-facet pathology explaining the pain, and meet documented response thresholds to diagnostic blocks. Diagnostic confirmation requires ≥80% relief on two diagnostic blocks (or a dual-block paradigm), therapeutic procedures require documented ≥50% pain or functional improvement for specified durations, and RFA requires two diagnostic MBBs with ≥80% relief; imaging guidance (fluoroscopy/CT), documentation of scales, provider credentialing, and specified frequency limits apply.

"Moderate to severe chronic axial neck or low back pain causing functional deficit, present ≥3 months, with documented failure to respond to noninvasive conservative management."