In simple words: The doctor uses a special x-ray or CT scan to guide a needle into the joint of your neck or upper back that connects two vertebrae, or into the nerves around this joint.Medicine is injected to help diagnose or treat back pain. This is done on one side at a single level.

This code represents an injection of a diagnostic or therapeutic substance into the paravertebral facet joint or the nerves supplying that joint in the cervical or thoracic spine, using image guidance (fluoroscopy or CT). It is for a single level injection.Imaging guidance and localization are required. If imaging is not used, report 20552, 20553. If ultrasound guidance is used, report 0213T, 0214T, 0215T, 0216T, 0217T, or 0218T. When determining a level, count the number of facet joints injected, not the number of nerves injected. Therefore, if multiple nerves of the same facet joint are injected, it would be considered a single level. Add-on codes (64491, 64492) are used for additional levels injected at the same session. For bilateral injections at the same level, use modifier 50.

Example 1: A patient presents with neck pain localized to the C5-C6 level. Following a diagnostic medial branch block, a therapeutic injection of anesthetic and steroid is performed at the C5-C6 facet joint under fluoroscopic guidance., A patient with thoracic back pain at the T3-T4 level undergoes a single level facet joint injection with a local anesthetic and steroid under CT guidance., A patient experiences chronic neck pain stemming from the C7-T1 facet joint.Following diagnostic workup confirming the source of pain, they undergo a therapeutic facet joint injection at this level using fluoroscopy.

Documentation should include: patient history and physical exam findings, imaging reports confirming the diagnosis, informed consent, details of the injection procedure (including medication used, needle placement, and imaging guidance used), and post-procedure assessment.