2025 CPT code 62290

Injection procedure for discography, each level; lumbar.

* Report only one code per level injected.* Contrast injection and fluoroscopic guidance are inclusive.* Do not report separately if imaging (x-ray or CT scan) is performed as part of this procedure.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual and payer guidelines for modifier usage.

Medical necessity for discography is established when conservative treatment for chronic lower back pain fails to provide adequate relief, and imaging studies such as MRI or CT show inconclusive results. The procedure is used to identify specific disc pathology as the source of the pain to guide treatment decisions.

The physician performs the procedure under fluoroscopic guidance, injecting contrast material into the lumbar intervertebral disc. The physician interprets the results of the injection and subsequent imaging.

In simple words: This test uses a special dye and X-rays to check your lower back discs. The doctor injects the dye into a disc to see if it causes pain, helping determine if a specific disc is causing back pain problems.

Lumbar discography, also known as a discogram, is a diagnostic procedure involving the injection of contrast material into the nucleus pulposus of a lumbar intervertebral disc under fluoroscopic guidance.The procedure aims to visualize the disc and assess its integrity, helping identify the source of back pain.The injection may temporarily reproduce the patient's pain symptoms, aiding in diagnosis.Fluoroscopic imaging is an integral part of the procedure and is not separately reported.

Example 1: A patient presents with chronic lower back pain.A discogram is performed to identify the specific disc(s) causing pain, potentially guiding surgical intervention such as discectomy or spinal fusion., A patient has undergone conservative treatment (physical therapy, medication) for lower back pain without relief. A discogram is performed to differentiate discogenic pain from other sources, informing treatment decisions., Pre-operative evaluation for spinal fusion.A discogram helps pinpoint the specific affected disc levels requiring surgical intervention, improving surgical planning and precision.

* Detailed patient history, including location, character, and onset of back pain.* Physical examination findings.* Pre-procedure consent form.* Imaging reports (pre- and post-injection fluoroscopy and potentially CT or MRI).* Documentation of pain reproduction during injection at specific levels.* Post-procedure notes and patient follow-up.

** The injection of contrast material during lumbar discography can cause temporary discomfort or pain that mimics the patient's chronic back pain. This pain response helps pinpoint the source of the problem. If the contrast material spreads outside the disc, it may indicate tears or damage.

  • Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
  • Payment Status: Active
  • Specialties:* Pain Management* Neurosurgery* Orthopedic Surgery* Interventional Radiology
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center
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