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Head/Face
ICD-10 Diagnoses: Atypical facial pain (G50.1); Cervicogenic or suboccipital headache (R51); Cluster headache, not intractable (G44.009); Occipital neuralgia (M54.81); Post-dural puncture “spinal” headache (G97.1); Temporomandibular joint disorder, unspecified (M26.60); Tension-type headache, unspecified, not intractable (G44.209); Trigeminal neuralgia (G50.0).

CPT Procedures: Greater occipital nerve block – 64405 (injection, occipital nerve); Lesser occipital or other peripheral nerve block – 64450 (used for small peripheral nerves, e.g. lesser occipital nerve or other head/neck nerves); Trigeminal nerve block (any division) – 64400; Sphenopalatine ganglion block – 64505 (for SPG block via intranasal or injection); Temporomandibular joint injection – 20605 (intermediate joint injection, e.g. TMJ); 77002 (fluoroscopic guidance for non-spinal injection, if applicable, add-on)kneewell.com. Botulinum toxin injections: 64615 (chemodenervation of facial/trigeminal/cervical muscles for chronic migraine); 64616 (chemodenervation of neck muscles, e.g. for cervical dystonia); J0585 (Botulinum toxin Type A per unit, medication) for Botox or Dysport; J0587 (Botulinum toxin Type B per 100 units) for Myobloc.

Cervical Spine (Neck)
ICD-10 Diagnoses: Neck pain (cervicalgia, M54.2); Cervical degenerative disc disease – high cervical (M50.31), mid-cervical (M50.32), C7/T1 level (M50.33); Cervical disc herniation – high cervical (M50.21), mid-cervical (M50.22), C7/T1 (M50.23); Torticollis/Cervical dystonia (M43.6); Cervical facet joint syndrome (M54.02); Post-laminectomy syndrome, cervical (M96.1); Cervical radiculopathy (M54.12) and cervicothoracic radiculopathy (M54.13); Radiculopathy due to cervical disc disorder – high cervical (M50.11), mid-cervical (M50.12), C7/T1 (M50.13); Cervical spinal stenosis (M48.02); Cervical spondylosis without myelopathy/radiculopathy (M47.812); Cervical spondylosis with radiculopathy (M47.22); Cervical spondylolisthesis (M43.12) and cervicothoracic spondylolisthesis (M43.13); Whiplash – sprain of ligaments of cervical spine (S13.4XXA/D* for initial/subsequent encounter); Strain of muscle/tendon at neck level (S16.1XXA/D*). (7th character A = initial encounter, D = subsequent, S = sequela.)

CPT Procedures: 62321 – Interlaminar epidural steroid injection (ESI), cervical or thoracic (with imaging guidance included)cms.gov; 64479 – Transforaminal ESI, cervical or thoracic, single level (includes fluoroscopic or CT guidance)cms.gov; 64480 – each additional cervical/thoracic level (transforaminal), add-on; 64490 – Facet joint intra-articular injection or medial branch block, cervical or thoracic, 1st level; 64491 – second level; 64492 – third level (max 3 levels per side typically); 64633 – Radiofrequency ablation (RFA) of facet joint nerve (medial branch) in cervical/thoracic region, 1st joint; 64634 – each additional joint (cerv/thoracic), up to 3 per side; 77003 – Fluoroscopic guidance for spinal injection (e.g. facet blocks or RFA needle placement) as applicable. (Note: CPT codes for spine injections include imaging guidance by definition, so fluoroscopy should not be billed separatelycms.gov.) Additional cervical procedures: 64510 – Stellate ganglion block (cervical sympathetic block for CRPS or vascular pain); 64405/64450 – Greater or third occipital nerve blocks (for C2-3 facet/TON, often coded as facet block at C2/3 or occipital nerve block as above). Spinal cord stimulation: see 63650 etc under “Neurostimulation” below for cervical SCS trials and implants. Trigger point injections: 20552 (into 1–2 muscles), 20553 (3 or more muscles) for cervical paraspinals/trapezius if indicated.

Thoracic Spine
ICD-10 Diagnoses: Upper back/thoracic spine pain (M54.6); Osteoporotic compression fracture of vertebra (pathological fracture) – e.g. osteoporosis with current pathological vertebral fracture, site unspecified (M80.88XX); Collapsed thoracic vertebra, not elsewhere classified (M48.54XA initial, M48.54XD subsequent); Collapsed vertebra, thoracolumbar region (M48.55XA/D); Thoracic degenerative disc disease (M51.34) and thoracolumbar DDD (M51.35); Thoracic disc herniation (M51.24) and thoracolumbar disc herniation (M51.25); Diffuse idiopathic skeletal hyperostosis [DISH] of thoracic spine (M48.10); Post-laminectomy syndrome of thoracic spine (M96.1); Intercostal neuropathy (G58.0); Thoracic radiculopathy NOS (M54.14); Thoracic radiculopathy due to disc disorder (M51.14) and thoracolumbar (M51.15); Rib sprain (S23.41XA/D*); Thoracic spine sprain (ligaments) (S23.3XXA/D*); Scoliosis (M41.X, code to type/region); Thoracic spinal stenosis (M48.04); Thoracic spondylosis without myelopathy (M47.814); Thoracic spondylosis with myelopathy (M47.14); Syringomyelia/syringobulbia (G95.0); Thoracic outlet syndrome (G54.0).

CPT Procedures: 62321 – Interlaminar ESI, cervical or thoracic (used for thoracic epidural injections, includes imaging); 64479/64480 – Transforaminal ESI for cervical/thoracic levels (T12-L1 is coded as cervical/thoracic level)cms.gov; 64490-64492 – Facet joint or medial branch blocks, cervical/thoracic (for upper thoracic pain, similar codes as cervical); 64633/64634 – Facet RFA for cervical/thoracic joints (e.g. upper thoracic facets); 64420 – Intercostal nerve block, single level; 64421 – Intercostal nerves, multiple levels (each additional); 64530 – Celiac plexus block (for upper abdominal visceral pain, typically via T12 approach); 64520 – Block of thoracic or lumbar sympathetic nerves (e.g. ganglion impar or lower thoracic sympathetic chain); 22510 – Percutaneous vertebroplasty, cervicothoracic, first level; 22511 – vertebroplasty, lumbosacral, first level; +22512 – each additional vertebral level vertebroplasty; 22513 – Kyphoplasty (percutaneous vertebral augmentation), thoracic, first level; 22514 – Kyphoplasty, lumbar, first level; +22515 – each additional level for kyphoplasty. (Vertebroplasty/kyphoplasty include any imaging guidance and bone biopsy performed; do not add separate fluoro codes. Modifier -50 not applicable, as these are per vertebra procedures.)

Lumbar Spine
ICD-10 Diagnoses: Low back pain (lumbago, M54.5); Ankylosing spondylitis of lumbar region (M45.6) or lumbosacral (M45.7); Arachnoiditis, unspecified (G03.9); Bertolotti’s syndrome (congenital lumbosacral transitional anomaly, Q76.49); Osteoporosis with current pathologic fracture, vertebra (age-related, M80.08XA/D); Collapsed vertebra NOS, lumbar region (M48.56XA/D); Lumbar degenerative disc disease (M51.36) and lumbosacral DDD (M51.37); Lumbar disc herniation (M51.26) and lumbosacral disc herniation (M51.27); Lumbar disc displacement with myelopathy (M51.06); Lumbar facet joint syndrome (M54.06) and lumbosacral (M54.07); Postlaminectomy syndrome, lumbar (M96.1); Iliolumbar ligament sprain (sprain of lumbar spine ligaments, S33.5XXA/D*); Lumbosacral plexus disorder (G54.4); Lumbar radiculopathy (M54.16) and lumbosacral radiculopathy (M54.17); Radiculopathy due to lumbar disc disorder (M51.16) and lumbosacral (M51.17); Lumbar spinal stenosis, central (M48.061 without neurogenic claudication; M48.062 with claudication); Lumbosacral stenosis (M48.07X – specify neurogenic claudication if applicable); Spinal stenosis due to disc displacement (M99.53, segmental and somatic dysfunction in lumbar region); Foraminal stenosis due to spondylosis (M99.63) or due to disc bulge/soft tissue (M99.73); Lumbar spondylolisthesis (M43.16) and lumbosacral spondylolisthesis (M43.17); Spondylolysis, congenital (Q76.2) vs acquired (M43.06); Lumbar spondylosis without myelopathy (M47.816) and lumbosacral without myelopathy (M47.817); Spasm of back muscles (M62.830); Lumbar spine sprain (S33.5XXA/D*); Lumbar strain (muscle/tendon), e.g. lumbar sprain/strain unspec. (S39.012X*).

CPT Procedures: 62323 – Interlaminar ESI, lumbar or sacral (including caudal epidural); 64483 – Transforaminal ESI, lumbar or sacral, single level (includes fluoro/CT guidance)cms.gov; 64484 – each additional lumbar/sacral level, transforaminal; (For bilateral lumbar TFESI, use 64483 with modifier -50 for two sides at one levelcms.gov.) 64493 – Facet joint or medial branch block, lumbar or sacral, 1st level; 64494 – second level; 64495 – third level (max 3 levels per side); 64635 – Facet joint RFA, lumbar or sacral, 1st joint; 64636 – each additional lumbar/sacral facet joint; 27096 – Sacroiliac joint injection, therapeutic, with fluoroscopic or CT guidance (see SI section); 77003 – Fluoroscopic guidance for spinal injections (included in above epidural/transforaminal/facet codes, not billed separately). Other lumbar procedures: 64517 – Superior hypogastric plexus block (for pelvic pain, via L5/S1); 64520 – Ganglion impar block (via coccyx for coccydynia or pelvic pain); 63650 – Spinal cord stimulator trial lead placement, percutaneous (10-day global); 63655 – SCS surgical lead placement via laminectomy (paddle lead, 90-day global); 63685 – SCS generator implant or replacement (10-day global); 63661 – Removal of SCS percutaneous electrode array; 63662 – Removal of SCS laminectomy paddle lead; 63688 – Removal of SCS implantable pulse generator. (When implanting SCS leads, also bill HCPCS L8680 per lead for the neurostimulator electrode arrays.) 62290 – Lumbar discography (provocative discogram), each lumbar disc injected; 72295 – Fluoroscopic discogram interpretation and post-discography imaging, lumbar, each level.

Sacrum & SI Joint / Pelvis
ICD-10 Diagnoses (Sacrum, SI, Buttock): Sacroiliac joint dysfunction or pain (e.g. arthropathy, M12.9); Sacroiliitis, not elsewhere classified (M46.1); SI joint sprain (S33.6XXA/D*); Coccydynia (tailbone pain, M53.3); Piriformis syndrome with sciatica – right (G57.01), left (G57.02); Cluneal nerve neuritis (neuritis/neuropathy of cluneal nerves, M79.2); Sacral and sacrococcygeal spondylosis (M47.818).
ICD-10 Diagnoses (Hip/Pelvis/Thigh): Osteoarthritis of hip – right (M16.11), left (M16.12) (or pain in hip: right M25.551, left M25.552); Greater trochanteric bursitis – right (M70.61), left (M70.62); Ischial bursitis – right (M70.71), left (M70.72); Gluteal tendinitis (enthesopathy) – right (M76.01), left (M76.02); Iliotibial band syndrome – right (M76.31), left (M76.32); Meralgia paresthetica (lateral femoral cutaneous nerve entrapment) – right (G57.11), left (G57.12); Femoral nerve lesion (mononeuropathy) – right (G57.21), left (G57.22); Pain in thigh/leg (unspecified leg pain) – right (M79.604), left (M79.605); Hamstring muscle/tendon strain – right (S76.311A), left (S76.312A) (7th char A/D for initial/subseq.); Pelvic region and thigh muscle or tendon strain (S76.** category, code by specific muscle).

CPT Procedures (SI/Sacrum/Pelvis): 27096 – Sacroiliac joint injection (therapeutic anesthetic/steroid injection, with fluoroscopic or CT guidance); 20552 – Trigger-point injection code often used for SI joint injection without image guidance (injecting SI region as a “trigger point”); 64450 – Lateral branch nerve blocks of sacral nerves (e.g. S1-S3 lateral branches innervating SI joint) – use multiple units for each nerve branch, and 77003 for fluoroscopic guidance (spinal) if performing lateral branch blockskneewell.com; 64635 – Radiofrequency ablation of L5 dorsal ramus (for SI joint denervation, lumbar region first joint code); 64640 – RFA of peripheral nerve (e.g. sacral lateral branch), used for each sacral lateral branch nerve ablation (report 3× 64640 for S1, S2, S3, with modifiers for multiple procedures). Piriformis injection (e.g. for piriformis syndrome) can be done as a trigger point injection 20552 (if injecting the muscle belly) or as a sciatic nerve block 64445 (if targeting the sciatic nerve near piriformis); 64450 may also be used for blockade of the superior gluteal nerve or pudendal nerve if needed (unlisted peripheral nerve). Hip joint injection: 27093 – Injection procedure for hip arthrography (often used for therapeutic hip injections with fluoro guidance; add 77002 for fluoro); or 20610 for major joint injection without image guidance (hip is a major joint). Peripheral nerve blocks (lower extremity): Femoral nerve block – 64447 (injection, femoral nerve); Lateral femoral cutaneous nerve block – typically coded 64450 (other peripheral nerve). Superior cluneal nerve block (for lower back/buttock pain) – 64450. Superior hypogastric plexus block: 64517 (via anterior approach or transdiscal at L5). Ganglion impar block: 64520 (for coccydynia, via sacrococcygeal junction).

Knee
ICD-10 Diagnoses: Knee osteoarthritis – primary OA of right knee (M17.11), left knee (M17.12) (generalized OA formerly 715.16apta.org); Prepatellar bursitis – right (M70.41), left (M70.42); Pes anserine or other knee bursitis – right (M70.51), left (M70.52); Chondromalacia of patella – right (M22.41), left (M22.42); Meniscus tear – (code depends on medial vs lateral and horn, e.g. bucket-handle tear of lateral meniscus, right knee: S83.242A); Knee pain (pain in joint, knee) – right (M25.561), left (M25.562); Patellar tendinitis (jumper’s knee) – right (M76.51), left (M76.52)icdcodes.ai; Peroneal nerve injury/lesion – right (S84.11XA), left (S84.12XA) (common peroneal nerve trauma). (Note: S-code injuries require 7th char for encounter A/D/S.)

CPT Procedures: 20610 – Major joint/bursa injection or aspiration (knee joint injection, also for shoulder or hip)bracedirect.com; this is used for therapeutic knee injections (steroid, viscosupplement, etc.) or arthrocentesis. 64450 – Genicular nerve blocks (use 64450 for each genicular nerve branch block around the knee, typically 3 branches – e.g. superomedial, superolateral, inferomedial genicular nerves – bill 3 units)bracedirect.com. 64640 – Radiofrequency ablation of genicular nerves (report 64640 three times, one for each nerve ablated, with modifier -59 on second and third to denote separate nerves). (Genicular nerve blocks/RFA are used for chronic knee pain, e.g. osteoarthritis.) 64447 – Femoral nerve block (for anterior knee innervation, if needed); 64445 – Sciatic nerve block (for posterior knee innervation, less common in isolated knee pain). Knee bracing – see DME section for common knee orthosis codes (e.g. unloading brace L1843/L1851, post-op hinged brace L1832/L1833, etc.bracedirect.com).

Ankle/Foot
ICD-10 Diagnoses: Achilles tendinitis/bursitis – right (M76.61), left (M76.62)outsourcestrategies.com; Plantar fasciitis (calcaneal spur syndrome, M72.2); Metatarsalgia (forefoot pain, e.g. Morton’s toe) – right (M77.41), left (M77.42); Morton’s neuroma (interdigital neuralgia) – right foot (G57.61), left (G57.62); Ankle/foot pain (joint pain) – right (M25.571), left (M25.572); Tarsal tunnel syndrome (posterior tibial nerve entrapment) – right (G57.51), left (G57.52).

CPT Procedures: 20600 – Small joint/bursa injection (for toes, small joints of foot); 20605 – Intermediate joint injection (ankle joint, subtalar, etc. without imaging); 64455 – Injection anesthetic agent, plantar common digital nerve (Morton’s neuroma injection); 64450 – Posterior tibial nerve block (tarsal tunnel injection can be coded as “other peripheral nerve”); 64450 – Saphenous nerve block at ankle (if needed for medial ankle pain); 64450 – Supraorbital or peroneal nerve blocks as applicable (other peripheral nerves, code once per nerve). (Use an appropriate nerve block code for any peripheral nerve injections not specified by their own code.) Orthotics and braces for foot/ankle pain are listed in DME section (e.g. lace-up ankle brace L1902, ankle stirrup L1906, walking boot L4361/L4387).

Other Lower Extremity
ICD-10 Diagnoses: Complex Regional Pain Syndrome type I (CRPS I, reflex sympathetic dystrophy) of lower limb – right (G90.521), left (G90.522), bilateral (G90.523); CRPS type II (causalgia) of lower limb – right (G57.71), left (G57.72); Phantom limb pain (pain in amputated limb) (G54.6).

CPT Procedures: 64520 – Lumbar sympathetic block (e.g. for CRPS of leg, blocks lumbar sympathetic chain); 64450 – Peripheral nerve blocks as needed for focal CRPS pain (e.g. tibial nerve, etc.); 97032 – TENS unit application (if used for pain relief in CRPS, see Modalities); 64590 – Insertion of peripheral nerve stimulator electrode (if dorsal root ganglion stimulator or peripheral nerve stimulation considered, unlisted if specific code not available). (Treatment of CRPS may involve sympathetic blocks, PT, TENS, or spinal cord stimulation – see SCS codes above.)

Shoulder
ICD-10 Diagnoses: Shoulder pain (M25.511 right; M25.512 left); Adhesive capsulitis of shoulder (frozen shoulder) – right (M75.01), left (M75.02); Bicipital tendinitis – right (M75.21), left (M75.22); Subacromial bursitis (subdeltoid bursitis) – right (M75.51), left (M75.52); Scapulothoracic bursitis/snapping scapula (other specified lesions of shoulder) – right (M75.81), left (M75.82); Shoulder impingement syndrome – right (M75.41), left (M75.42); Superior glenoid labrum lesion (SLAP tear) – right (S43.431A), left (S43.432A) [initial injury]; Osteoarthritis of shoulder (glenohumeral joint) – right (M19.011 or M19.031unspecified vs primary), left (M19.012/M19.032); Acromioclavicular joint arthritis (M19.111 right, M19.112 left) or sprain (S43.51X*); Sternoclavicular joint sprain (S23.420A/D); Rotator cuff muscle or tendon strain/tear – right (S46.011X), left (S46.012X). Paresthesias in arm/hand (tingling/numbness) – R20.2 (unspecified site).

CPT Procedures: 20610 – Major joint injection (shoulder joint injection or aspiration, e.g. glenohumeral or subacromial bursa injection)bracedirect.com; 23350 – Injection procedure for shoulder arthrography (for glenohumeral joint under fluoroscopic guidance, add 77002 for fluoro); 77002 – Fluoro guidance for joint injections if needed (add-on)kneewell.com; 64415 – Brachial plexus block (for shoulder analgesia, e.g. interscalene block for shoulder surgery pain); 64418 – Suprascapular nerve block (for shoulder pain, targets suprascapular nerve); 64450 – Other peripheral nerve block (e.g. axillary nerve block if needed); 23472 – Surgical repair of rotator cuff (if coding surgical procedures, not typically in office). (For spasticity or dystonia of shoulder girdle muscles, chemodenervation 64614 may be used – see Botox section.) Common shoulder supports: L3670 – Clavicle strap (figure-8 brace) for clavicle fracturepromedeast.com; slings (A4565, basic arm sling).

Elbow
ICD-10 Diagnoses: Lateral epicondylitis (tennis elbow) – right (M77.11), left (M77.12); Medial epicondylitis (golfer’s elbow) – right (M77.01), left (M77.02); Olecranon bursitis – right (M70.21), left (M70.22); Ulnar neuropathy at elbow (cubital tunnel syndrome) – right (G56.21), left (G56.22); Median nerve lesion (pronator syndrome or other median neuropathy, excluding carpal tunnel) – right (G56.11), left (G56.12); Radial nerve palsy (Saturday night palsy) – right (G56.31), left (G56.32); Elbow sprain (collateral ligament injury) – e.g. S53.4XXA; Elbow strain – S56.11XA, etc.

CPT Procedures: 20605 – Intermediate joint injection (e.g. elbow joint aspiration/injection); 20550 – Injection, tendon sheath or ligament (e.g. common extensor tendon origin for lateral epicondylitis, or medial flexor tendon for medial epicondylitis, De Quervain’s at wrist, etc.); 20526 – Injection, carpal tunnel (wrist) – sometimes used for cubital tunnel by injection near ulnar nerve at elbow (off-label, or use 64450 as peripheral nerve block for ulnar nerve); 64450 – Ulnar nerve block at elbow (for cubital tunnel pain relief); 24300 – Manipulation under anesthesia, elbow (if applicable in surgical setting); 97014 – E-stim therapy (for epicondylitis therapy – see Modalities); L3702 – Elbow orthosis (hinged elbow brace, if needed post-injury).

Wrist/Hand
ICD-10 Diagnoses: Carpal tunnel syndrome – right (G56.01), left (G56.02); Ulnar tunnel syndrome at wrist – right (G56.41), left (G56.42) or Lesion of ulnar nerve NOS (cubital tunnel listed above for elbow); de Quervain’s tenosynovitis (radial styloid tenosynovitis, M65.4); Trigger finger (stenosing tenosynovitis) – M65.30 (unspecified finger) [individual fingers have specific codes M65.31–M65.37]; Wrist osteoarthritis – right (M19.031), left (M19.032); Hand osteoarthritis – right (M19.041), left (M19.042); Wrist sprain (S63.501A etc. by ligament); Hand sprain (S63.621A etc.); Acquired wrist drop (secondary radial nerve palsy) – right (M21.331), left (M21.332); Tendon injury of hand/wrist – various S56 codes by tendon.

CPT Procedures: 20600 – Small joint injection (wrist, carpals, or hand/finger joints); 20550 – Tendon sheath injection (e.g. for trigger finger release – flexor tendon sheath, or De Quervain’s first dorsal compartment injection); 20551 – Tendon origin/insertion injection (e.g. lateral epicondylitis at elbow, or golfer’s elbow – see above; less used in hand); 20526 – Carpal tunnel injection (inject median nerve area at carpal tunnel for CTS); 96401/96372 – Therapeutic drug injection (for systemic meds IM/SC if needed, e.g. IM ketorolac J1885, which requires an injection administration codeoutsourcestrategies.com). Splinting/bracing: Wrist-hand orthosis (e.g. cock-up wrist splint) – L3908 (prefabricated WHFO)bracedirect.com; Thumb spica splint – L3923 (thumb spica, prefab) for de Quervain’s or thumb arthritisenovis.com.

Other Upper Extremity
ICD-10 Diagnoses: Complex Regional Pain Syndrome type I of upper limb – right (G90.511), left (G90.512), bilateral (G90.513); CRPS type II (causalgia) of upper limb – right (G56.41), left (G56.42) – e.g. causalgia of median or ulnar nerve in arm; Brachial plexus lesion (G54.0 not accurate here – G54.0 is TOS, see below); Thoracic outlet syndrome – G54.0 (brachial plexus compression at thoracic outlet). Other systemic pain-related: Fibromyalgia (M79.7); Myalgia (M79.1) – actually M79.1 is fibromyalgia, M79.7 is fibromyalgia? (Correction: Fibromyalgia M79.7, Myalgia M79.1); Polymyalgia rheumatica (M35.3).

CPT Procedures: 64510 – Stellate ganglion block (for CRPS of arm); 64415 – Brachial plexus block (e.g. interscalene or supraclavicular for shoulder/arm pain); 64450 – Other peripheral nerve blocks in arm (median, ulnar, radial at forearm if needed); 97014 – Electrical stimulation therapy, cutaneous (for CRPS or other neuropathic pain – see Modalities); 97010 – Hot/cold pack therapy (for fibromyalgia flares, etc. – see Modalities); 98925-98929 – Osteopathic Manipulative Treatment (OMT) codes, by number of body regions (may use for fibromyalgia or myofascial pain patients in addition to standard E/M).

Rheumatologic Conditions (common diagnoses encountered alongside pain)
ICD-10 Diagnoses: Ankylosing spondylitis – of thoracolumbar spine (M45.5), lumbar (M45.6), lumbosacral (M45.7); Rheumatoid arthritis, unspecified (M06.9); Gout, unspecified (M10.00); Systemic lupus erythematosus, unspecified (M32.9); Polymyositis with myopathy (M33.22); Dermatomyositis with myopathy (M33.92); Polymyalgia rheumatica (M35.3); Other inflammatory spondylopathies (M46.x).

CPT/Management: Typically medical management (DMARDs, etc.) and therapy – not specific procedural codes in pain practice beyond possible trigger point injections or OMT for muscle pain, and 96372 for medication injections. 97036 – Hubbard tank/whirlpool (for gout flare perhaps); 20550 – tendon sheath injections if gouty tophi in tendons; J codes for injectable meds (steroids like J1100 for dexamethasone, etc. – see Injectables section).

Psychological Conditions (common in pain patients, often coded as comorbidities)
ICD-10 Diagnoses: Anxiety disorder (generalized anxiety disorder, F41.1); Depression (major depressive disorder, recurrent, unspecified, F33.9); Insomnia, unspecified (G47.00); Restless legs syndrome (G25.81); Chronic pain syndrome (G89.4) – if using a chronic pain diagnosis code for a centralized pain condition. (These diagnoses may accompany pain visits; treatment often via counseling or medication management – E/M codes apply. No specific CPT procedure codes except therapy codes if provided by mental health professionals.)

Electrodiagnostic Testing
EMG & Nerve Conduction Study CPT Codes: 95905 – Nerve conduction study, 1-2 studies (2023+ code update; previously 95907)simplepractice.com; 95907 – 1-2 nerve conduction studies (older coding, now 95905 for 2023+); 95908 – 3-4 NCS; 95909 – 5-6 NCS; 95910 – 7-8 NCSinjuryprevention.bmj.com; 95911 – 9-10 NCS; 95912 – 11-12 NCS; 95913 – 13 or more NCS. 95900 – Motor nerve conduction, each nerve (without F-wave); 95903 – Motor NCS with F-wave, each; 95904 – Sensory NCS, each nerve. 95934 – H-reflex, soleus (usually tibial nerve/ankle reflex test); 95936 – H-reflex, other than soleus (e.g. upper limb); 95933 – Blink reflex (facial nerve) test. 95885 – Needle EMG, each extremity, limited (with NCS on same day); 95886 – Needle EMG, each extremity, complete; 95887 – Needle EMG, non-extremity (e.g. paraspinal muscles). 95860 – Needle EMG, one extremity (no NCS same day); 95861 – two extremities; 95863 – three extremities; 95864 – four extremities. 95867 – Needle EMG, cranial nerve supplied muscles, unilateral (e.g. laryngeal EMG); 95868 – cranial nerve EMG, bilateral. (EMG needle electrode is included in the EMG service, not separately billable.) Add modifier -26 for professional component if using equipment owned by another entity.

Therapeutic Procedures & Modalities

• Acupuncture: 97810 – Acupuncture, initial 15 min without electrical stimulation; 97813 – Acupuncture, initial 15 min with electrostim; 97811/97814 – each additional 15 min without/with stim (add-on codes).
  
  

• Physical Medicine Modalities: 97010 – Hot or cold packs therapy; 97012 – Mechanical traction therapy (e.g. lumbar traction); 97024 – Diathermy (e.g. microwave heat therapy); 97035 – Ultrasound therapy (therapeutic ultrasound); 97032 – Electrical stimulation (manual), each 15 min (attended e-stim); G0283 – Unattended electrical stimulation (e.g. TENS unit application) for pain control; 97530 – Therapeutic activities (direct one-on-one, by 15 min); 97535 – Self-care/Home management training (15 min increments, e.g. teaching use of TENS at home, exercises); 97110 – Therapeutic exercise (each 15 min); 97140 – Manual therapy techniques (15 min, e.g. myofascial release).
  
  

• Osteopathic Manipulative Treatment (OMT): 98925 – OMT, 1-2 body regions; 98926 – 3-4 regions; 98927 – 5-6 regions; 98928 – 7-8 regions; 98929 – 9-10 regions. (Note: When OMT is done on the same day as other procedures like injections, typically fewer regions are billed to reflect limited treatment in conjunction.)
  
  

• Epidural Blood Patch: 62273 – Injection, epidural blood patch (to treat post-dural puncture headache).
  
  

• Moderate Sedation (Conscious Sedation): 99152 – Moderate sedation services by same provider (first 15 minutes, patient age 5+); 99153 – each additional 15 minutes. (Older codes 99144/99145 were for 30 min +15 min; replaced in 2017 by 99151–99157 series.)
  
  

Injectable Medications (HCPCS “J-codes”): Common drugs used in pain procedures – J1100 (Dexamethasone, per 1 mg); J0702 (Betamethasone acetate/phosphate compound, per 3 mg – e.g. Celestoneoutsourcestrategies.com); J0704 (Betamethasone 6 mg/ml, per 4 mg); J1030 (Methylprednisolone acetate 40 mg, e.g. Depo-Medrol 40); J1040 (Depo-Medrol 80 mg); J3301 (Triamcinolone acetonide, 10 mg, e.g. Kenalog per 10 mg unit); J1885 (Ketorolac tromethamine, per 15 mg – e.g. 30 mg IM requires 2 units – note: use 96372 for intramuscular therapeutic injection administration); J2800 (Methocarbamol up to 1000 mg IM/IV, e.g. Robaxin injectable – use with 96372 if IM); J2250 (Midazolam, per 1 mg IV – if used for sedation); J3010 (Fentanyl citrate, 0.1 mg IV – for sedation or analgesia); J1200 (Diphenhydramine 50 mg injectable, IV/IM). Viscosupplement injections: J7325 (Hyaluronan or derivative for intra-articular injection, per dose – covers many brands of viscosupplements; some use J7325 with modifiers for specific products, e.g. J7325 appended with ‘-SJ’ for Synvisc-One® 6 mL single injection). Contrast agents: Q9967 (Omnipaque 300 contrast per ml used) and Q9966 (Omnipaque 240 per ml) for myelography, discography, or arthrogram injections if not provided by facility. (J-codes are typically billed for medication supply when used in physician office setting.)

Durable Medical Equipment (DME) – Common Braces and Devices: (HCPCS L-codes for orthoses, typically billed separately)

• Cervical Collars: L0120 – Cervical collar, foam (non-rigid, e.g. soft collar); L0170 – Cervical collar, plastic adjustable (Philadelphia collar, semi-rigid).
  
  

• Spinal Orthoses (Back Braces): L0650 – Lumbar-sacral orthosis, high-strength rigid, prefabricated, off-the-shelf (e.g. LSO with anterior-posterior rigid panels)advanced-orthopaedics.comenovis.com; L0648 – LSO, rigid, prefabricated (similar to L0650, different fitting classification)advanced-orthopaedics.com; L0637 – LSO, custom-fitted (equivalent custom code to L0650 OTS)advanced-orthopaedics.com; L0627 – Lumbar support orthosis, with rigid stays or panels (prefabricated); L0456 – Thoracolumbar orthosis, TLSO rigid shell (e.g. Jewett hyperextension brace).
  
  

• Shoulder/Clavicle Braces: L3660 – Clavicle strap, figure-8 type for clavicle fracture alignmentpromedeast.com; A4565 – Sling (non-coded basic medical sling supply).
  
  

• Elbow/Wrist/Hand Braces: L3760 – Elbow immobilizer (e.g. static progressive stretch elbow device); L3908 – Wrist-hand orthosis, prefab (cock-up wrist splint)bracedirect.com; L3916 – Wrist-hand orthosis, adjustable (e.g. custom fit WHO)bracedirect.com; L3923 – Hand-finger orthosis, includes thumb (thumb spica splint), prefabenovis.com; L3924 – thumb spica, custom molded (if needed for long-term use).
  
  

• Knee Orthoses: L1820 – Knee orthosis, elastic with hinges (neoprene sleeve with hinges, no rigid support); L1830 – Knee immobilizer (rigid knee brace, no joint, full extension); L1832 – Knee orthosis, adjustable knee joints (ROM dial locks), custom fitted (post-op hinged knee brace, custom fit)bracedirect.com; L1833 – Same as L1832 but off-the-shelf (prefabricated)bracedirect.com; L1843 – Unloading/off-loading knee brace, custom fitted (e.g. single-upright valgus brace for unicompartmental OA)bracedirect.com; L1851 – Unloading knee brace, off-the-shelf (prefab version of L1843)bracedirect.com; L1845 – Knee orthosis, dual uprights, ligamentous support, custom (e.g. custom ACL brace)bracedirect.com; L1852 – Ligament knee brace, dual uprights, off-the-shelf (prefab version of L1845)bracedirect.com. (Knee braces are coded based on whether they are custom-fitted vs off-the-shelf, per Medicare requirementsbracedirect.com.)
  
  

• Ankle/Foot Orthoses: L1902 – Ankle brace, elastic with stays (e.g. lace-up ankle support)cms.gov; L1906 – Ankle orthosis, multiligamentous support, prefab (e.g. semi-rigid stirrup brace)cms.gov; L4350 – Ankle control orthosis, boot walker type (may refer to pneumatic walking boot – older code, replaced by L4360/61); L4361 – Walking boot, pneumatic (aircast walker), prefabricated, off-the-shelfassociationdatabase.com; L4360 – Walking boot, pneumatic, custom fitted (similar to L4361 for custom)associationdatabase.com; L4387 – Walking boot, non-pneumatic, prefabricated (rigid boot without air)bracedirect.com; L4386 – Walking boot, non-pneumatic, custom fittedmed.noridianmedicare.com. (Walking boots are considered ankle-foot orthoses (AFOs) – codes L4360/L4361 for pneumatic, L4386/L4387 for non-pneumaticmed.noridianmedicare.com.)
  
  

• Knee Continuous Passive Motion Device: E0935 – Continuous passive motion (CPM) exercise device for use on knee only (typically a rental device post knee surgery)med.noridianmedicare.com.
  
  

• Static/Dynamic Knee Stretch Devices: E1811 – Static progressive stretch knee device (e.g. Kneewell™ for improving knee extension/flexion); Medicare considers E1811 a capped rental DME item (rent up to 13 months, then purchase)kneewell.comkneewell.com. E1810 – Dynamic knee flexion/extension device (adjustable stretch device). (These devices help improve knee range of motion after injury or surgery.)
  
  

Modifiers (Commonly Used):

• -50 – Bilateral procedure (used when the same procedure is performed on both sides, same session)
  
  

• -51 – Multiple procedures (same session, not typically used if CPTs are flagged for multi-procedure auto-adjustment)
  
  

• -59 – Distinct procedural service (indicates procedures are separate and not bundled – e.g. two injections in different sites)
  
  

• -52 – Reduced services (partial procedure not completed as planned, not due to complication/endangerment)
  
  

• -53 – Discontinued procedure (physician elected to terminate procedure due to patient well-being, e.g. vasovagal event stopping an RFA mid-procedure)
  
  

• -26 – Professional component only (when billing for interpretation/services without owning equipment, e.g. EMG performed on hospital-owned machine)
  
  

• -LT / -RT – Left or right side (for DME like braces, or bilateral anatomy procedures when required instead of -50 by payer).
  
  

• -GA – Waiver of liability on file (indicates an ABN form signed for a usually non-covered service)
  (Ensure to use appropriate modifiers per coding guidelines. For example, -50 for bilateral facet blocks will usually only reimburse up to bilateral 3 levels; for bilateral SCS leads, use -50 if applicable, etc.)
  
  

Cannabis-Related Diagnoses:

• F12.90 – Cannabis use, unspecified, uncomplicated – used to indicate a patient’s cannabis use without meeting criteria for abuse or dependence (e.g. supervised medical marijuana use)findacode.com. (Coding clinics advise using F12.90 for documented medical cannabis use, as it is not considered abuse or dependencefindacode.com.)
  
  

• F12.20 – Cannabis dependence, uncomplicated – cannabis use disorder (moderate/severe) without intoxication or complication (use for Cannabis Use Disorder diagnosis). F12.10 – Cannabis abuse, uncomplicated (mild use disorder).
  
  

• R11.16 – Cannabis Hyperemesis Syndrome (CHS) – cyclical vomiting due to cannabis useicd10data.com (often in chronic high-dose users). Code R11.16 is new; “Cannabinoid hyperemesis syndrome” should be coded R11.16, with an additional code for the cannabis use disorder (F12.x) if applicableicd10data.com.
  
  

• Z79.899 – Other long term (current) drug therapy – sometimes used to indicate long-term use of a medication not otherwise specified (some providers might list this for chronic medical cannabis use under physician supervision in the absence of a DSM diagnosis).
  
  

• Z91.89 – Other specified personal risk factors (could optionally document patient’s use of cannabis for medical reasons here, though not a specific code for cannabis, it indicates a personal habit or risk factor).
  
  

Sources: Key coding references and guidelines were used to compile the above, including CPT 2024 descriptors, ICD-10-CM 2025 codes, and payer policiesaafp.orgcms.gov. Additional information on bracing and DME codes is drawn from PDAC/Medicare DME guidelinesbracedirect.comkneewell.com, and cannabis-use coding follows ICD-10-CM official guidancefindacode.comicd10data.com. This outline combines common diagnosis codes (ICD-10) with corresponding procedure codes (CPT/HCPCS) relevant to a musculoskeletal injury and pain management practice, ensuring no provided codes were omitted and adding commonly missing items (e.g. medical cannabis use, CHS, bracing L-codes, knee CPM devices).