Medicare WISeR service

Epidural Steroid Injections for Pain Management

The selected state’s effective Medicare Administrative Contractor policy controls. CPT 62323 is in scope only for epidural-steroid-injection indications in the applicable LCD.

Documentation overview

Documentation categories to review

These categories summarize the approved criteria bundle. The note checker uses the selected state, clinical pathway and procedure details to apply the relevant criteria.

Core and jurisdiction-specific documentation

  • Qualifying diagnosis with supporting history, physical examination, and radiology
  • Pain severity measured at baseline and follow-up
  • Conservative-care trial or documented failure
  • Frequency and repeat-session documentation
  • Image guidance and approach documentation
  • Sedation justification, when applicable
  • Active rehabilitation program
  • Absence of contraindications
  • In Arizona and Washington, the selected steroid and lowest effective dose

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Educational use only

This page summarizes public CMS documentation criteria. It does not provide medical, legal or coding advice, determine Medicare coverage, predict prior-authorization outcomes, or replace clinical judgment. Coverage decisions are made by CMS and its contractors. Verify the effective policy for the patient’s date and place of service before relying on this summary.