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2025 CPT code 62280

Injection/infusion of a neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without another therapeutic substance, into the subarachnoid space.

Follow all applicable CPT coding guidelines and payer-specific instructions for reporting this procedure.Adhere to anatomical specificity and ensure appropriate documentation supports the procedure's medical necessity.

Modifiers may be applicable depending on the circumstances of the procedure, such as the use of anesthesia or the extent of the procedure.Consult the CPT manual and payer guidelines for specific modifier usage.

Medical necessity for 62280 is established when a patient suffers from severe, intractable pain not adequately controlled by conservative measures, and the neurolytic injection is deemed the most appropriate treatment option by a qualified physician.Specific payer criteria should be reviewed as they can vary.

A physician specializing in interventional pain management, anesthesiology, or neurology typically performs this procedure. The physician is responsible for selecting the appropriate neurolytic and other therapeutic agents, determining the injection site and technique, and monitoring the patient's response to the procedure.Pre-procedure and post-procedure care may also be included.

IMPORTANT:Related codes include 62281 (epidural injection) and other codes for injections into different spinal spaces or using different substances.For procedures involving only the administration of non-neurolytic substances, refer to codes 62320-62327.

In simple words: This code describes a procedure where a doctor injects a medication into the spinal fluid to numb or kill nerves causing severe pain, often from cancer.Other medications might be added. The doctor uses imaging (like X-rays) to guide the injection.

This CPT code encompasses the injection or infusion of a neurolytic agent (such as alcohol, phenol, or iced saline solutions) into the subarachnoid space of the spinal column.The procedure may also include the administration of other therapeutic substances in conjunction with the neurolytic agent.The injection is performed under imaging guidance, typically fluoroscopy, to ensure accurate placement of the needle or catheter.The neurolytic substance is used to destroy nerve tissue, usually to alleviate intractable pain.

Example 1: A patient with intractable cancer pain in the lower back, unresponsive to other treatments, undergoes a subarachnoid injection of phenol under fluoroscopic guidance to ablate the affected nerves., A patient with severe neuropathic pain following a spinal cord injury receives a subarachnoid injection of alcohol and a local anesthetic to relieve pain in specific spinal nerve roots., A patient with failed back surgery syndrome experiences severe pain.A neurolytic injection into the subarachnoid space is performed under CT guidance using a combination of alcohol and a steroid to manage the pain, reducing the need for long-term opiate use.

Detailed patient history including pain location, duration, intensity, and previous treatments.Imaging studies (e.g., MRI, CT) to identify the affected nerve roots or structures.Consent form signed by the patient.Operative report detailing the procedure, including substance injected, injection site, volume, and any complications.Post-operative pain assessment and follow-up care.

** Ultrasonic guidance may be used in addition to or in place of fluoroscopy.The choice of neurolytic agent and other therapeutic substances will vary depending on the patient's specific needs and the physician's clinical judgment.Always adhere to established safety protocols and pain management best practices when performing this procedure.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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