2025 CPT code 62264
(Active) Effective Date: N/A Revision Date: N/A Surgery - Injection, Drainage, or Aspiration Procedures Surgical Procedures on the Spine and Spinal Cord Feed
Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter), including radiologic localization (includes contrast when administered); multiple adhesiolysis sessions, same day.
Modifiers 51 (multiple procedures) and 52 (reduced services) may be applicable depending on the circumstances.
Medical necessity for this procedure is established when a patient exhibits symptoms of nerve root compression caused by epidural adhesions that have not responded to conservative management, such as physical therapy, medications, or injections.
The physician is responsible for performing the procedure, including patient preparation, anesthesia administration (if applicable), image guidance, catheter placement (if any), injection of contrast medium and therapeutic agents, and post-procedure care.
In simple words: This code describes a procedure to remove scar tissue in the spine that's pressing on nerves.A doctor uses imaging to guide a thin tube or injects medicine to dissolve or break up the scar tissue.This is done in multiple sessions on the same day.
This CPT code, 62264, encompasses the percutaneous lysis of epidural adhesions.The procedure involves the use of solution injection (such as hypertonic saline or enzyme) or mechanical means (like a catheter) to break down these adhesions. Radiologic localization, including the administration of contrast material when necessary, is an integral part of the procedure.This code specifically applies to multiple adhesiolysis sessions performed on the same day. Fluoroscopic guidance and localization (77003) are inclusive components of this code.The procedure is not reported for each adhesiolysis treatment session; instead, it represents the entire series of injections/infusions performed during the day.
Example 1: A patient presents with chronic low back pain and leg pain radiating down to the foot consistent with lumbar radiculopathy, possibly due to epidural adhesions. The physician performs a percutaneous epidural adhesiolysis using a catheter and hypertonic saline solution under fluoroscopic guidance to lyse adhesions in multiple sessions on the same day., A patient with post-surgical spinal stenosis and significant epidural scarring experiences worsening radicular pain. The physician performs a percutaneous adhesiolysis using enzymatic solutions via catheter and fluoroscopy in two separate treatment sessions during the same day to alleviate the pain., A patient with a history of prior spine surgery and persistent nerve root compression presents with severe back and leg pain. The physician performs an adhesiolysis procedure using mechanical disruption via catheter during multiple fluoroscopically-guided sessions on the same day, in an attempt to relieve the nerve compression.
* Detailed history and physical examination documenting the patient's symptoms and the location of the pain.* Imaging studies (e.g., MRI, CT) demonstrating the presence of epidural adhesions.* Operative report detailing the technique used (catheter or injection, type of solution, number of injections), the fluoroscopic guidance utilized, and the location of the adhesions.* Post-procedure imaging may be required to document changes in the epidural space after the procedure.* Documentation of the patient's response to treatment, including pain relief and any complications.
** This procedure is often referred to as a Racz procedure or epidural neurolysis. The choice of solution (hypertonic saline, enzyme, or other) and the method of adhesiolysis (mechanical disruption or chemical dissolution) should be documented in the operative report.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- Global Days: This procedure does not have a global surgical period as defined by the CPT guidelines.It is reported only once per day for multiple sessions on that same day.
- Payment Status: Active
- Modifier TC rule: Technical Component (TC) modifier is not applicable to this code.
- Specialties:Anesthesiology, Neurosurgery, Pain Management
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient/Outpatient)