A new study published in The Spine Journal examines how bundling codes for facet injections impacts the Medicare population.
The researchers examined 100 percent of the Medicare Part B claims submitted for facet joint injections from 2000 to 2012 documented in the CMS Physician Supplier Procedure Summary master files. They analyzed the trends in changes over those years, paying specific attention to the 2010 when CPT were bundled with image guidance and injections were limited up to three levels.
The researchers found:
1. Facet injection increased from 2000 to 2012 with an 11 percent average growth rate per year for lumbo-sacral facet injections; there was a 15 percent increase in cervical-thoracic facet injections.
2. The largest jump — 25 percent growth per year for lumbo-sacral injections and 32 percent for cervical-thoracic injections — occurred between 2000 to 2006.
3. The growth leveled off from 2007 to 2012 with a negative 3 percent per year growth of lumbo-sacral injections and negative 2 percent growth for cervical-thoracic injections.
4. The 2010 calendar year showed the biggest drop in facet joint injections, with a 14 percent drop for lumbo-sacral facet injections and 15 percent drop for the cervical-thoracic facet injections.
5. The researchers concluded the biggest drop correlated with the new CPT codes that bundled image guidance and limited the procedure to three levels or less.