How facet joint injection CPT bundles for imaging affected utilization: 5 key notes

Spine

A study published in The Spine Journal examines facet joint injections and the impact of bundling CPT codes had on utilization.

The study authors analyzed Medicare Part B claims submitted for patients who underwent facet joint injections over a 12-year period, 2000 to 2012. CPT changed coding for facet joint injections in 2012, bundling image guidance with the procedure. The image guidance could include CT or fluoroscopy. CPT also limited billing to a three-level maximum due to increased utilization.

 

The researchers found:

 

1. Between 2000 and 2012, the facet joint injections increased an average of 11 percent per year for lumbosacral facet joint injections and 15 percent for cervical-thoracic facet injections per 100,000 Medicare enrollees.

 

2. The biggest jump was in the first six years of the study period, when lumbosacral joint injections grew 25 percent per year and the cervical-thoracic injections were up 32 percent per year per 100,000 Medicare enrollees.

 

3. Utilization leveled off between 2007 and 2012 when lumbosacral joint injections experienced a 3 percent decline and cervical-thoracic injections had a 2 percent decline per 100,000 Medicare enrollees.

 

4. The CPT bundling codes appears to have made a difference; the biggest drop in utilization was in 2010 when lumbosacral facet joint injections dropped 14 percent and cervical-thoracic facet joint injections dropped 15 percent per 100,000 Medicare beneficiaries.

 

5. The researchers concluded the biggest drop "correlated with the release of new CPT codes that bundled image guidance and limited procedures to three levels or fewer."

 

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