2025 CPT code 96450

Administration of chemotherapy into the central nervous system (e.g., intrathecal), including a lumbar puncture.

This code includes the lumbar puncture. Report only one initial chemotherapy administration code per encounter, even if multiple drugs are given sequentially. Modifier 52 may be appended if another provider performs the lumbar puncture and this provider only administers the chemotherapy injection.

Modifiers such as 22 (Increased Procedural Services), 52 (Reduced Services), and others may be applicable depending on the specific circumstances of the service provided.

Medical necessity must be established based on the patient's specific diagnosis, clinical condition, and treatment plan. Intrathecal chemotherapy is typically justified when there is a risk or presence of cancer in the CNS.

This procedure is typically performed by an oncologist or other qualified healthcare professional specializing in cancer treatment. They are responsible for the entire procedure, including patient assessment, obtaining informed consent, administering the lumbar puncture, injecting the chemotherapy, and post-procedure care.

In simple words: The doctor injects chemotherapy drugs directly into the fluid surrounding the spinal cord to treat or prevent cancer in the central nervous system. This involves a spinal tap procedure.

This code represents the administration of chemotherapy drugs into the patient's central nervous system (CNS), such as the spinal cord.The procedure involves a lumbar puncture (spinal tap) where a needle is inserted into the lower back to access the spinal canal. The chemotherapy is then injected into the cerebrospinal fluid. This method is often used for treating certain types of cancers that affect the CNS or to prevent spread to the CNS.

Example 1: A patient with leukemia receives intrathecal chemotherapy to prevent or treat leukemic cells in the CNS., A patient with lymphoma affecting the spinal cord receives intrathecal chemotherapy as part of their treatment plan., A patient with a brain tumor receives intrathecal chemotherapy to prevent or treat spread of cancer cells to the cerebrospinal fluid.

Documentation should include details of the lumbar puncture procedure, type and dosage of chemotherapy administered, patient response to treatment, and any complications encountered. The medical necessity for the procedure must also be clearly documented.

** For intravesical chemotherapy administration, use code 51720. For insertion of a subarachnoid catheter and reservoir for infusion, use codes 62350, 62351, or 62360-62362. For insertion of an intraventricular catheter and reservoir, use 61210 or 61215. If fluoroscopic guidance is used during the procedure, report code 77003.

  • Specialties:Oncology, Hematology, Neurosurgery (for cases where a separate provider may perform the lumbar puncture), Pain Medicine (for symptom management related to the procedure)
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office, and possibly other locations if clinically appropriate.
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