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The procedure described by CPT® Code 62263 involves the percutaneous lysis of epidural adhesions, which are fibrous bands of scar tissue that can form in the epidural space and may contribute to pain or neurological symptoms. This procedure utilizes the injection of one or more substances, such as hypertonic saline or enzymes, to break down these adhesions. The process begins with the preparation of the skin over the injection site, which includes cleansing and the administration of a local anesthetic to minimize discomfort. Radiologic guidance, typically fluoroscopy, is employed to accurately position a spinal needle into the epidural or caudal vertebral space at the targeted vertebral level. Once the needle is correctly placed, a catheter is threaded through it into the epidural space, allowing for the delivery of therapeutic agents directly to the site of adhesion. The use of contrast material is crucial as it helps confirm the correct placement of the catheter and allows for the assessment of the surrounding nerve roots and spinal nerves. The procedure may involve multiple injections, with substances such as hyaluronidase, local anesthetics, and steroids being administered to facilitate the lysis of adhesions. The timing and sequence of these injections are carefully planned, with contrast being used to verify catheter positioning before each injection. This comprehensive approach aims to alleviate pain and restore function by effectively addressing the scar tissue that may be impeding nerve function. CPT® Code 62263 is specifically used when these injections are performed over a span of two or more days, distinguishing it from similar procedures conducted in a single day, which would be coded differently.
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The procedure described by CPT® Code 62263 is indicated for patients experiencing pain or neurological symptoms due to the presence of epidural adhesions. These adhesions can result from previous surgeries, trauma, or inflammatory conditions affecting the spine. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 62263 involves several detailed steps to ensure effective lysis of epidural adhesions:
After the completion of the procedure, patients may be monitored for any immediate adverse reactions or complications. It is essential to assess the effectiveness of the injections in alleviating pain and improving function. Patients may be advised on post-procedure care, which could include rest, pain management strategies, and follow-up appointments to evaluate the outcomes of the treatment. The recovery process may vary depending on the individual and the extent of the adhesions treated. Continuous assessment of symptoms and functional improvement is crucial in determining the success of the procedure.
| Short Descr | EPIDURAL LYSIS MULT SESSIONS | Medium Descr | PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS | Long Descr | Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 5 - Insertion of catheter or spinal stimulator and injection into spinal canal |
| SG | Ambulatory surgical center (asc) facility service | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2003-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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