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The procedure described by CPT® Code 62320 involves the injection of diagnostic or therapeutic substances into the epidural or subarachnoid space of the cervical or thoracic region of the spine. This procedure is performed without the use of imaging guidance. Prior to the injection, the skin over the targeted spinal area is thoroughly cleansed with an antiseptic solution to minimize the risk of infection. A local anesthetic is then administered to numb the area, ensuring patient comfort during the procedure. A thin spinal needle or catheter is carefully inserted into the back, accessing either the epidural space, which is the outermost area of the spinal canal filled with cerebrospinal fluid, or the subarachnoid space, which is located closer to the spinal cord. The subarachnoid space is situated between the arachnoid membrane and the pia mater, the innermost protective layer surrounding the spinal cord. In some cases, contrast dye may be injected prior to the therapeutic substance to confirm the correct placement of the needle and to visualize the flow of medication into the desired area, a process known as epidurography. The substances injected can include anesthetics, antispasmodics, opioids, steroids, or other solutions, but do not include neurolytic substances. After the injection, the patient is monitored for any potential adverse effects, ensuring their safety and well-being. This code is specifically used for interlaminar epidural or subarachnoid injections in the cervical or thoracic regions without imaging guidance, distinguishing it from other related codes that specify different regions or the use of imaging techniques.
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The procedure associated with CPT® Code 62320 is indicated for various conditions that may benefit from the administration of diagnostic or therapeutic substances into the epidural or subarachnoid space. These indications include:
The procedure for CPT® Code 62320 involves several critical steps to ensure proper administration of the injection. First, the healthcare provider prepares the patient by positioning them comfortably, typically in a seated or lying position, to access the cervical or thoracic region of the spine. The skin over the targeted area is then cleansed with an antiseptic solution to reduce the risk of infection. Following this, a local anesthetic is injected to numb the area, enhancing patient comfort during the procedure. Next, a thin spinal needle or catheter is carefully inserted into the back, utilizing either a paramedian or midline interlaminar approach to access the epidural or subarachnoid space. The provider may palpate anatomical landmarks to ensure accurate placement. In some cases, contrast dye may be injected first to confirm the correct positioning of the needle, allowing for visualization of the medication's flow into the desired area. Once proper placement is confirmed, a diagnostic or therapeutic substance, such as an anesthetic, antispasmodic, opioid, steroid, or a combination of these, is injected into the epidural or subarachnoid space. It is important to note that neurolytic substances are excluded from this procedure. After the injection, the patient is monitored for any adverse effects, ensuring their safety and well-being throughout the process.
After the completion of the injection procedure, the patient is typically monitored for a short period to observe for any immediate adverse reactions or complications. This monitoring phase is crucial to ensure that the patient does not experience any unexpected side effects from the injected substances. Patients may be advised to rest and avoid strenuous activities for a specified period following the injection to allow for optimal recovery. Additionally, healthcare providers may provide instructions regarding pain management, activity restrictions, and signs of potential complications that should prompt immediate medical attention. Follow-up appointments may be scheduled to assess the effectiveness of the injection and to determine if further treatment is necessary. Overall, the post-procedure care is aimed at ensuring patient safety and maximizing the therapeutic benefits of the injection.
| Short Descr | NJX INTERLAMINAR CRV/THRC | Medium Descr | NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN | Long Descr | Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance | Status Code | Active Code | Global Days | 000 - Endoscopic or 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) | 9 - Concept 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 0777T | Add-on Code MPFS Status: Carrier Priced APC N Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure) |
| 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | KX | Requirements specified in the medical policy have been met | GZ | Item or service expected to be denied as not reasonable and necessary | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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 | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2017-01-01 | Added | Added |
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