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The procedure described by CPT® Code 62282 involves the injection or infusion of a neurolytic substance, which may include agents such as alcohol, phenol, or iced saline solutions. These neurolytic substances are specifically designed to destroy neural structures that are involved in the perception of pain, thereby providing long-lasting relief from pain. This procedure is commonly referred to as a neurolytic block and is particularly indicated for patients suffering from chronic, intractable, non-terminal pain that has not responded to other pain management strategies, as well as for those experiencing cancer-related pain. The neurolytic block can be administered either through injection or infusion into specific areas of the spine, namely the subarachnoid space or the epidural space. The subarachnoid space is located between the arachnoid mater and the pia mater, while the epidural space is situated between the bony structures of the spine and the dura mater, which is the outermost membrane covering the spinal cord. The procedure typically requires the patient to be positioned on an X-ray table with their back exposed, ensuring optimal access to the injection site. Prior to the injection, the area is cleansed, and a local anesthetic is applied to minimize discomfort. Fluoroscopic guidance, which is a type of real-time imaging, is utilized to accurately insert a spinal needle or cannula into the appropriate space. A small amount of contrast material is injected to confirm the correct positioning of the needle or cannula before the neurolytic substance is administered. It is important to note that different CPT codes are used for various levels of injection: CPT® Code 62280 is designated for subarachnoid injections at any spinal level, CPT® Code 62281 is for epidural injections in the cervical or thoracic regions, and CPT® Code 62282 is specifically for epidural injections in the lumbar or sacral (caudal) region.
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The procedure described by CPT® Code 62282 is indicated for the following conditions:
The procedure begins with the patient being positioned on an X-ray table, ensuring that the back is exposed for access to the injection site. The area where the injection will be administered is thoroughly cleansed to reduce the risk of infection. Following this, a local anesthetic is applied to the site to minimize discomfort during the procedure. Using fluoroscopic guidance, which provides real-time imaging, a spinal needle or cannula is carefully inserted into either the subarachnoid space or the epidural space, depending on the specific treatment being performed. To confirm that the needle or cannula is correctly positioned, a small amount of contrast material is injected. This step is crucial as it allows the physician to visualize the placement of the needle or cannula within the spinal anatomy. Once proper positioning is verified, the neurolytic substance—such as alcohol, phenol, or iced saline—is then injected or infused into the targeted area. This neurolytic agent works to destroy the neural structures involved in pain perception, thereby providing the patient with long-lasting pain relief.
After the procedure, patients are typically monitored for any immediate adverse reactions or complications. It is essential to observe the patient for signs of infection, bleeding, or neurological deficits. Depending on the patient's condition and the extent of the procedure, they may be advised to rest and avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to assess the effectiveness of the neurolytic block and to determine if additional treatments are necessary. Patients should also be informed about potential side effects and the expected duration of pain relief, as well as any signs that would warrant immediate medical attention.
| Short Descr | TREAT SPINAL CANAL LESION | Medium Descr | INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL | Long Descr | Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 5 - Insertion of catheter or spinal stimulator and injection into spinal canal |
This is a primary code that can be used with these additional add-on codes.
| 77003 | CPT Add On MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure) |
| 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). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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) | SG | Ambulatory surgical center (asc) facility service | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| Pre-1990 | Added | Code added. |
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