CCSD code A5750 – Medial branch block under X-ray control

Key takeaways

CCSD code A5750 was a medial branch block code, under X-ray control and covering 1 to 2 levels. It was never a facet joint injection code.

A5750 does not appear in Bupa’s February 2026 schedule, which lists medial branch blocks by spinal region as A5743, A5744 and A5745.

Facet joint injections are billed as A5773 (cervical), A5774 (thoracic) or A5775 (lumbar), codes that took effect on 2 January 2020.

The current descriptors read +/- image guidance (including bilateral), so imaging is optional and a bilateral injection sits inside the same code.

UK insurers expect a WHO ICD-10 diagnosis such as M47.8 or M54.5, not a US ICD-10-CM code such as M47.816.

Pabau stores your CCSD procedure codes in one library and sends private insurer invoices through Healthcode.

What is CCSD code A5750?

CCSD Code A5750 is the code UK private insurers used for a medial branch block (under X-ray control) covering 1 to 2 levels. The schedule is maintained by the Clinical Coding and Schedule Development (CCSD) Group, and every major UK private medical insurer bills against it.

A5750 sat in Chapter 3 of the schedule (spine, spinal cord and peripheral nerves), in the paraspinal injections category. That category holds medial branch blocks, facet joint injections, nerve root blocks, neurolytic blocks, epidurals and sacroiliac joint injections.

The code no longer appears in the current Bupa schedule. The Bupa CCSD reference (February 2026) lists medial branch blocks as three regional codes instead. An invoice that still carries A5750 is using a legacy code, so it is likely to come back for correction.

A5750 is not a facet joint injection code

A5750 is easy to confuse with a facet joint injection code, but it described a medial branch block. A medial branch block and a facet joint injection treat the same joints by different routes, and CCSD codes them separately.

• Medial branch block. The needle targets the medial branches of the dorsal rami, the small nerves that carry pain signals from the facet joints. Local anaesthetic is placed beside the nerve, not inside the joint.
• Facet joint injection. The needle enters the facet (zygapophyseal) joint itself, or the tissue around it. Steroid and local anaesthetic go into or around the joint capsule.

The legacy codes were counted by the levels or joints treated, while the current ones are split by spinal region. The table and diagram below map each legacy code to the current codes that describe the same procedure.

The facet joint codes A5773, A5774 and A5775 took effect on 2 January 2020. The joint-count codes A5751, A5761 and A5771 are no longer in the schedule. Each current code reads “Facet joint injection(s) +/- Image Guidance (including Bilateral)”, followed by the spinal region.

What a medial branch block involves

A medial branch block is mainly a diagnostic test. It tells the consultant whether the facet joints are the source of the patient’s neck or back pain.

1. Positioning. The patient lies prone for lumbar and thoracic levels, or in a position that exposes the neck for cervical levels.
2. Targeting. The consultant identifies each level and advances a fine needle to the medial branch, usually with fluoroscopy or CT guidance.
3. Injection. A small volume of local anaesthetic is placed at each medial branch, sometimes with steroid.
4. Assessment. The patient records their pain over the following hours, often in a pain diary. A clear, short-lived reduction points to the facet joints as the source.

A positive block often leads to radiofrequency denervation, which CCSD codes separately as a neurolytic root block (A5763 to A5766). NICE guideline NG59 recommends radiofrequency denervation only in people with chronic low back pain after a positive response to a diagnostic medial branch block.

NG59, which covers low back pain, also advises against spinal injections for managing low back pain. Insurers may apply similar thinking when they review an authorisation request, so the clinical case matters as much as the code.

Which current code to bill instead of A5750

Choose the current code from two facts in the procedure note: what the needle targeted, and which spinal region was treated. The grid below covers the paraspinal injections a pain practice bills most often.

Sacroiliac joint injection under image guidance, including bilateral, has a single code of its own: A5790. It is not split by region.

The current descriptors differ from A5750 in three ways that change how you bill:

• Image guidance is optional. “+/- image guidance” means the code applies with or without imaging, so imaging is no longer the test for the right code.
• Bilateral work is included. An injection on both sides at the same region sits inside one code.
• There is no level or joint count. The descriptors name a region only. How an insurer pays for several levels, or two regions in one session, is a matter of its own policy.

Because no joint count is written into the code, confirm the insurer’s approach before you book a multi-region session. Record every region, level and side in the procedure note either way.

Neighbouring CCSD codes in Chapter 3 paraspinal injections

The table shows the category and fee Bupa lists for each neighbouring code in its February 2026 schedule. A dash means Bupa lists no category or fee for that code, so check the insurer’s own schedule before quoting a patient.

Fees are Bupa’s published maximums for the consultant and change over time. Other insurers set their own fees against the same CCSD codes. For codes outside the paraspinal injections category, start from our CCSD code library.

ICD-10 diagnosis codes to pair with the current codes

UK private insurers use the WHO edition of ICD-10, not the US ICD-10-CM. A US code such as M47.816 has no place on a UK claim, so use the WHO equivalent instead.

Use the most specific code the clinical record supports. A confirmed spondylosis diagnosis is more specific than a pain code, so it usually belongs first on the claim.

Pre-authorisation and insurer checks

UK private medical insurers generally ask members to get authorisation before planned treatment. Each insurer sets its own rules for paraspinal injections, so check the member’s policy before you book.

When you request authorisation, include:

• The WHO ICD-10 diagnosis code, such as M47.8 or M54.5
• Evidence of conservative treatment already tried, such as a physiotherapy discharge summary
• Relevant imaging reports, where they exist
• The current CCSD code for the planned procedure, with the region, levels and sides
• The performing consultant and the treating facility

Match the code on the invoice to the code that was authorised. If the plan changes on the day, for example from a medial branch block to a facet joint injection, contact the insurer before you invoice.

For a wider look at how Bupa CCSD procedure codes are structured, see our dedicated reference to the Bupa schedule.

What the procedure note should record

The procedure note is what an insurer checks when it queries a paraspinal injection claim. It should let a reviewer confirm the code without asking the consultant.

• The target: medial branch, facet joint, nerve root or epidural space
• The spinal region and each level treated
• The side, or both sides where the injection was bilateral
• Whether image guidance was used, and which modality
• The injectate, with agent, volume and concentration
• The patient’s response, and for a diagnostic block the pain scores afterwards

Digital forms in Pabau, the practice software we build, let you set fixed fields for region, level and side. A missing detail is then obvious before the note is signed.

Why claims on legacy code A5750 get queried

Most problems with A5750 come from old templates and copied invoices rather than clinical errors. Each cause below has a simple fix.

How Pabau keeps paraspinal injection claims on current codes

Many pain practices still carry A5750 in an old spreadsheet, a letter template or a saved invoice. Each copy has to be found and corrected by hand, and one missed copy is enough to send a claim back.

Pabau keeps CCSD codes in a single procedure library instead. Update A5743 to A5745 and A5773 to A5775 there once, and each new invoice picks up the current code.

Pabau’s claims management software then sends invoices to UK private insurers through Healthcode and tracks each claim’s status. For pain and musculoskeletal practices, that means less time chasing rejected spinal injection claims.

Stop legacy CCSD codes reaching your invoices

Pabau keeps your CCSD procedure codes in one library, adds them to invoices and sends claims to UK private insurers through Healthcode.

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Conclusion

A5750 belongs to an older version of the CCSD schedule, and it described a medial branch block rather than a facet joint injection. Treat any appearance of it on a claim as a prompt to recode.

The fix takes two questions: what the needle targeted, and which region it reached. Those answers point to a single current code, and the procedure note should state both.

Clearing legacy codes out of your templates once saves repeated corrections later. Book a demo to see how Pabau keeps CCSD codes current across every invoice your practice sends.

Continue your research

Need a complete Bupa coding reference for your practice? Bupa CCSD codes guide covers the full Bupa procedure schedule, fee structure, and invoicing rules for UK private practice.

Looking for end-to-end invoice and claim tracking software? Pabau claims management software automates invoice submission and tracks claim status across UK private insurers.

Looking up another UK procedure code? CCSD code library collects our guides to individual CCSD codes, with descriptors and the current codes to bill.

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