2025 CPT code 62263
(Active) Effective Date: N/A Revision Date: N/A Surgery - Injection, Drainage, or Aspiration Procedures on the Spine and Spinal Cord Surgical Procedures on the Spine and Spinal Cord Feed
Percutaneous lysis of epidural adhesions using injection or mechanical means, multiple sessions over 2 or more days; includes fluoroscopy and contrast.
Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 59 (distinct procedural service) may be required if the procedure is performed in conjunction with other services. Consult the most current CPT coding guidelines.
Medical necessity for percutaneous epidural lysis is established when conservative treatments (e.g., medication, physical therapy) have failed to alleviate the patient's pain and neurologic symptoms.Documentation must show that the patient's pain is caused by epidural adhesions and that the procedure is expected to improve the patient's condition.
The physician is responsible for pre-procedural preparation, including patient assessment and anesthesia considerations.They perform the percutaneous epidural catheter insertion, navigation within the epidural space, contrast injection for localization and assessment of the epidural space, injection of therapeutic agents or mechanical lysis of adhesions, and post-procedural care, including dressing application.The physician also interprets the imaging guidance.
- Surgical Procedures on the Spine and Spinal Cord
- Surgical Procedures on the Spine and Spinal Cord > Injection, Drainage, or Aspiration Procedures on the Spine and Spinal Cord
In simple words: This code describes a procedure to break up scar tissue in the spine that's pressing on nerves. A thin tube is inserted through the skin to reach the scar tissue.Special fluid or tools are used to break up the scar tissue, and images are used to guide the procedure. This happens over several days in multiple sessions, and all of that is included in one code.
This CPT code encompasses percutaneous lysis of epidural adhesions utilizing solution injection (e.g., hypertonic saline, enzyme) or mechanical methods (e.g., catheter), involving multiple adhesiolysis sessions spanning at least two treatment days.The procedure incorporates radiologic localization, which includes the administration of contrast material.Fluoroscopic guidance is an inclusive component.The code is reported once for the entire series of injections/infusions across the multiple treatment days, not for each individual session.
Example 1: A patient presents with chronic low back pain and radiculopathy due to post-surgical epidural scarring.The physician performs a percutaneous epidural lysis using a catheter over three days, injecting hypertonic saline and performing mechanical lysis with the catheter. Fluoroscopy with contrast is used for guidance and assessment. Code 62263 is reported., A patient experiences severe pain radiating down the leg following a lumbar laminectomy.Over a period of four days, the physician performs percutaneous epidural lysis using enzyme injections via a catheter.Fluoroscopic guidance with contrast is utilized to visualize the adhesions and ensure correct catheter placement. Code 62263 is reported., A patient with persistent low back pain after spinal fusion surgery undergoes percutaneous epidural lysis using a spring-wound catheter to lyse adhesions. The procedure is performed in two sessions, one day apart. Fluoroscopic guidance with contrast is used to verify catheter placement. Code 62263 is reported.
Detailed history and physical examination, including a description of the patient's pain and neurologic symptoms.Pre-procedure imaging (e.g., MRI or CT scan) to identify the location of adhesions.Operative report detailing the technique of catheter insertion, the type and amount of solution injected (or mechanical method used), the number of sessions, and the fluoroscopic images utilized.Post-procedure imaging to assess the result of the treatment.Physician's notes detailing the patient's response to the treatment and any complications.
** Specific reimbursement policies may vary by payer.Always check with the individual payer for their specific coverage guidelines and requirements for code 62263.
- Global Days: The global period for 62263 covers the entire series of injections/infusions spanning two or more days.Individual daily sessions are not separately coded.
- Payment Status: Active
- Modifier TC rule: The Technical Component (TC) modifier is not applicable to this code as it is a comprehensive procedure.
- Specialties:Pain Management, Neurosurgery, Anesthesiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center