CPT® Code 72275

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1. Indications

The indications for performing epidurography, as described by CPT® Code 72275, include the need to visualize the epidural space for diagnostic or therapeutic purposes. This procedure is typically indicated for patients experiencing specific symptoms or conditions related to spinal issues. The following are common indications for this procedure:

• Chronic Pain Patients suffering from chronic pain conditions that may benefit from targeted epidural interventions.
• Spinal Disorders Individuals with diagnosed spinal disorders, such as herniated discs or spinal stenosis, where imaging of the epidural space is necessary for treatment planning.
• Evaluation of Epidural Pathology Assessment of potential epidural pathologies, including tumors or infections, that may require further intervention.
• Pre-Procedure Planning Preparation for other spinal procedures that necessitate a clear understanding of the epidural anatomy and any existing abnormalities.

2. Procedure

The procedure for epidurography involves several critical steps to ensure accurate imaging and patient safety. The following outlines the procedural steps as described:

• Preparation of the Patient The procedure begins with the patient being positioned appropriately, typically lying on their stomach, to allow access to the spinal region. The skin over the targeted area is then cleansed thoroughly with an antiseptic solution to reduce the risk of infection.
• Administration of Local Anesthetic After the skin is prepared, a local anesthetic is injected to numb the area, ensuring that the patient remains comfortable throughout the procedure. This step is crucial for minimizing discomfort during the subsequent needle insertion.
• Insertion of the Spinal Needle A spinal needle is carefully inserted through the skin and advanced into the epidural space. The radiologist must ensure that the needle is placed correctly to avoid complications and to facilitate the injection of contrast material.
• Injection of Contrast Material Once the needle is in the correct position, contrast material may be injected to confirm proper needle placement. This step is essential for visualizing the epidural space accurately during imaging.
• Injection of Therapeutic or Diagnostic Substance Following the confirmation of needle placement, a therapeutic or diagnostic substance, such as an anesthetic, antispasmodic, opioid, steroid, or neurolytic agent, is injected into the epidural space. This injection can provide relief from pain or assist in diagnosing specific conditions.
• Imaging and Monitoring After the injection, radiological images are taken to document the condition of the epidural space. The patient is then monitored for 15 to 20 minutes to ensure there are no adverse effects from the procedure.

3. Post-Procedure

Post-procedure care for patients undergoing epidurography includes monitoring for any immediate adverse reactions to the injected substances. Patients are typically observed for a period of 15 to 20 minutes following the procedure to ensure stability. It is important to assess the patient for any signs of complications, such as increased pain, neurological deficits, or allergic reactions. After the monitoring period, patients may be provided with specific aftercare instructions, which could include recommendations for activity levels, pain management, and follow-up appointments to discuss the results of the imaging and any further treatment options based on the findings.