2025 CPT code 62281

Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic.

Refer to the current CPT coding guidelines and other relevant payer guidelines for specific instructions related to this procedure.

Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 59 (distinct procedural service) may be used if the procedure is performed separately from other services on the same day.Consult the appropriate modifier guidelines for further information.

Medical necessity is established by documentation of intractable pain refractory to conservative treatment methods.The procedure is indicated for severe pain that significantly impairs the patient's quality of life and interferes with daily activities.Specific details of pre-existing attempts at pain management should be documented and must be unsuccessful before this procedure is deemed medically necessary.

The procedure is typically performed by an anesthesiologist or interventional pain management specialist.The physician is responsible for patient assessment, selecting the appropriate neurolytic agent and other medication(s), precise needle placement under fluoroscopic guidance, injection or infusion, monitoring the patient's response, and post-procedure care instructions.Nursing staff assists with patient preparation, monitoring, and documentation.

IMPORTANT For non-neurolytic substances administered via injection or infusion into the subarachnoid or epidural space, refer to codes 62320-62327.For transforaminal epidural injection, see 64479-64484.Code 01996 is reported for daily hospital management of continuous epidural or subarachnoid drug administration performed in conjunction with 62324, 62325, 62326, 62327.

In simple words: The doctor injects a special medicine into your spine to relieve severe pain. This medicine helps numb or kill specific nerves causing the pain.The doctor uses X-ray imaging to guide the needle to the precise location. This might be done once or several times depending on your pain.

This CPT code encompasses the injection or infusion of a neurolytic substance, such as alcohol, phenol, or iced saline solutions, into the epidural space at the cervical or thoracic spinal level.The procedure may also include the administration of other therapeutic substances in conjunction with the neurolytic agent.Fluoroscopic guidance and contrast injection are integral components of this procedure. The neurolytic agent is used to selectively destroy nerves, providing pain relief for conditions like post-surgical pain after limb amputation or management of acute pain in conditions such as cancer. The procedure involves precise needle placement under fluoroscopic guidance, with potential contrast use for localization and verification of proper needle placement within the epidural space.A catheter may be used for infusion, reducing the risk of complications.The procedure may be repeated daily or intermittently for acute pain management.

Example 1: A patient presents with severe chronic pain following a traumatic limb amputation. The physician performs a fluoroscopically guided epidural injection of a neurolytic agent at the thoracic level to target specific nerves responsible for the intractable pain., A cancer patient experiences debilitating pain due to bone metastasis.The physician injects a neurolytic agent, combined with a steroid and anesthetic, into the epidural space at the cervical level via catheter. The catheter is removed once injection is completed. This is a single injection., A patient suffers from severe post-surgical pain after spinal fusion surgery. The physician inserts an epidural catheter and administers a series of neurolytic injections over three days.Code 62281 is reported only once for this series of treatments, as opposed to code 62284.

* Detailed history and physical examination documenting the indication for the procedure (e.g., intractable pain).* Imaging studies (e.g., X-rays, MRI) to delineate the location of the pain generator.* Operative report detailing the approach, needle placement, substances injected, volume administered, fluoroscopic images, and any complications.* Post-operative pain assessment and patient's response to treatment.* Note if other therapeutic substances were used and quantity.* Documentation that the patient was fully informed and consented to the procedure.

** This code includes fluoroscopic guidance and the injection of contrast material.The choice of neurolytic agent and other therapeutic substances should be clearly documented.

  • Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
  • RVU: Information not available.RVUs vary based on geographic location, facility type, and other factors. Consult your local Medicare Administrative Contractor (MAC) for specific relative value units and reimbursement rates.
  • Global Days : The global period is not explicitly defined for this code.The global period would likely depend on the individual circumstances and the specific payer's policies.Further clarification is needed from payer guidelines.
  • Payment Status: Active
  • Modifier TC rule: No Technical Component (TC) modifier applies. The code includes all aspects of the procedure.
  • Fee Schedule : Historical fee schedule information is not available.Contact your local Medicare Administrative Contractor (MAC) for fee schedule information.
  • Specialties:Anesthesiology, Pain Management, Neurosurgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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