Medicare: Reminder – Billing for Facet Joint Interventions for pain management and anesthesia

As of 4/25/2021, per LCD L35936, general anesthesia is considered not reasonable and necessary for facet joint interventions. Neither conscious sedation nor monitored anesthesia care is routinely necessary for intraarticular facet joint injections or medial branch blocks and is not routinely reimbursable. Individual consideration may be given on redetermination (appeal) for payment in rare, unique circumstances if the medical necessity of sedation is unequivocal and clearly documented in the medical record.

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