Joint injections will not resolve all horses' lamenesses because the lameness localized to a particular joint may be originating from the soft tissues surrounding the joint. However, many horses will only need to be injected one or a few times to achieve long term comfort. Sometimes a joint "flares" after injection, which is caused by inflammation that occurs secondary to the injection. However, this is rarely career limiting and can be treated easily with rest and pain medication. Any time you put a foreign object into the body there is a risk of infection, and this is possible with joint injections. However, your veterinarian uses precautions such as scrubbing the skin thoroughly and sometimes injecting antibiotics into the joint at the time of treatment to prevent infection from occurring. Lastly, administration of steroids into the joint can injure the cartilage over time, so it is wise to use joint medications sparingly and only when necessary.
When reporing facet joint codes, you may not bill separately for the image guidance. Whether using fluoroscopy or computed axial tomography, guidance is required. If ultrasound guidance is used for the above procedures, the CPT® codebook states that you must report the facet joint injection using 0213T-0218T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance… . If no imageing is used, you must report 20552-20553 Injection(s); single or multiple trigger point(s)….