Facet Joint Injections

Facet joint injections (diagnostic or therapeutic) performed under fluoroscopic or CT guidance for chronic (>3 months) axial lumbar or cervical pain suspected to be facet-mediated after ≥6 weeks of failed conservative therapy, with clinical exam/imaging excluding non‑facet causes (radiculopathy, myelopathy, neurogenic claudication; synovial cysts excepted). Coverage requires image guidance and an initial diagnostic local anesthetic block without corticosteroid, therapeutic injections only after ≥80% relief on diagnostic block (≥1 week later), limits of up to four diagnostic and four therapeutic injections per spinal region per rolling 12 months, and repeat/other-site injections only with documented prior benefit (≥50% pain reduction with ≥3 months functional improvement); exclusions include prior fusion at the level, unexplained neurologic deficit, active infection or coagulopathy, and failure to meet policy criteria.

"Facet joint injections performed under fluoroscopic or CT guidance."