Injection, Drainage, or Aspiration Procedures on the Spine and Spinal Cord 62263-62319

Cpt code for spinal injection

Injection of contrast during fluoroscopic guidance and localization is an inclusive component of 62263, 62264, 62267, 62270-62273, 62280-62282, 62310-62319. Fluoroscopic guidance and localization is reported with 77003, unless a formal contrast study (myelography, epidurography, or arthrography) is performed, in which case the use of fluoroscopy is included in the supervision and interpretation codes. Some of the injection technique of lumbar discogram and lumbar puncture procedure is also discussed in my previous post.
For radiologic supervision and interpretation of epidurography, use 72275. Code 72275 is only to be used when an epidurogram is performed, images documented, and a formal radiologic report is issued.


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Cpt code for Steroid spinal injection

Code 62263 describes a catheter-based treatment involving targeted injection of various substances (eg, hypertonic saline, steroid, anesthetic) via an indwelling epidural catheter. Code 62263 includes percutaneous insertion and removal of an epidural catheter (remaining in place over a several-day period), for the administration of multiple injections of a neurolytic agent(s) performed during serial treatment sessions (ie, spanning two or more treatment days). If required, adhesions or scarring may also be lysed by mechanical means. Code 62263 is not reported for each adhesiolysis treatment, but should be reported once to describe the entire series of injections/infusions spanning two or more treatment days.

Code 62264 describes multiple adhesiolysis treatment sessions performed on the same day. Adhesions or scarring may be lysed by injections of neurolytic agent(s). If required, adhesions or scarring may also be lysed mechanically using a percutaneously-deployed catheter.Codes 62263 and 62264 include the procedure of injections of contrast for epidurography (72275) and fluoroscopic guidance and localization (77003) during initial or subsequent sessions.

Fluoroscopy (for localization) may be used in the placement of injections reported with 62310-62319, but is not required. If used, fluoroscopy should be reported with 77003. For epidurography, use 72275.


Cpt code for Epidural spinal injection

The placement and use of a catheter to administer one or more epidural or subarachnoid injections on a single calendar day should be reported in the same manner as if a needle had been used, ie, as a single injection using either 62310 or 62311. Such injections should not be reported with 62318 or 62319.

Threading a catheter into the epidural space, injecting substances at one or more levels and then removing the catheter should be treated as a single injection (62310, 62311). If the catheter is left in place to deliver substance(s) over a prolonged period (ie, more than a single calendar day) either continuously or via intermittent bolus, use 62318, 62319 as appropriate. 

When reporting 62310-62319, code choice is based on the region at which the needle or catheter entered the body (eg, lumbar). Codes 62310-62319 should be reported only once, when the substance injected spreads or catheter tip insertion moves into another spinal region (eg, 62311 is reported only once for injection or catheter insertion at L3-4 with spread of the substance or placement of the catheter tip to the thoracic region).

Percutaneous spinal procedures are done with indirect visualization (eg, image guidance or endoscopic approaches) and without direct visualization (including through a microscope). Endoscopic assistance during an open procedure with direct visualization is reported using excision codes (eg, 63020-63035).
(Report 01996 for daily hospital management of continuous epidural or subarachnoid drug administration performed in conjunction with 62318-62319)


For injection procedure at C1-C2, use 61055 cpt code.



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