CPT® Code 0611T

1. Indications

The procedure identified by CPT® Code 0611T is indicated for the evaluation of discogenic pain, which may arise from various conditions affecting the intervertebral discs in the cervical, thoracic, or lumbar regions of the spine. The following conditions may warrant the use of magnetic resonance spectroscopy for assessment:

• Discogenic Pain Pain that originates from the intervertebral discs, often associated with degenerative disc disease or herniated discs.
• Chronic Back Pain Persistent pain in the back that may be linked to disc abnormalities.
• Neurological Symptoms Symptoms such as numbness, tingling, or weakness that may be related to disc pathology.

2. Procedure

The procedure for CPT® Code 0611T involves several critical steps to ensure accurate determination and localization of discogenic pain through magnetic resonance spectroscopy. The following procedural steps are undertaken:

• Data Acquisition The initial step involves acquiring magnetic resonance spectroscopy data from the intervertebral discs. This is performed using a magnetic resonance imaging (MRI) machine equipped with spectroscopy capabilities, which captures the biochemical information from the discs.
• Post-Processing After data acquisition, the MRS data undergoes a series of post-processing steps using specialized software. This includes optimal channel selection to enhance signal quality, phase error correction to rectify any discrepancies in the data, and frame editing to retain only high-quality frames for analysis.
• Signal Quality Enhancement The software performs additional corrections, such as frequency shift corrections, apodization, and coherent averaging, to improve the overall signal quality. Baseline correction and artifact filtering are also applied to eliminate any noise that may interfere with the analysis.
• Biomarker Quantification The processed data is then analyzed to calculate the concentrations of various biomarkers or metabolites present in the discs. These concentrations are expressed as peak values or ratios, which reflect the relative chemical differences between the discs.
• Ratio Calculation Ratios may be computed using pain marker values, such as alanine and lactic acid, in the numerator and structural integrity markers, like proteoglycan and carbohydrate/collagen, in the denominator. This normalization process generates a total MRS score for each disc, providing a comprehensive overview of the biochemical status.

3. Post-Procedure

Following the completion of the magnetic resonance spectroscopy procedure, the results are interpreted and reported separately under CPT® Code 0612T. The interpretation of the MRS disc biomarker data analysis is crucial for understanding the biochemical changes associated with discogenic pain. Clinicians may use this information to guide treatment decisions and further diagnostic evaluations. Patients may be advised on follow-up care based on the findings, which could include physical therapy, pain management strategies, or additional imaging studies if necessary.