How To Use CPT Code 62263

CPT 62263 describes the percutaneous lysis of epidural adhesions using solution injection or mechanical means, including radiologic localization, over multiple sessions. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62263?

CPT 62263 can be used to describe the percutaneous lysis of epidural adhesions using solution injection or mechanical means, including radiologic localization. This code is used when the provider performs the procedure over multiple sessions to remove adhesions in the epidural space.

2. Official Description

The official description of CPT code 62263 is: ‘Percutaneous lysis of epidural adhesions using solution injection or mechanical means, including radiologic localization, multiple adhesiolysis sessions; 2 or more days.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. Using fluoroscopy, the provider inserts a needle into the epidural space at the appropriate vertebral level.
3. A flexible catheter is then passed through the needle and into the epidural space.
4. The provider navigates the catheter to the target site where the adhesions are affecting the nerve root.
5. Contrast is injected to confirm the needle tip and catheter location, as well as to evaluate the flow of liquid and the extent of scarring.
6. The provider administers a chemical substance to dissolve the scar tissue and reduce inflammation and irritation on the nerve, or mechanically breaks up the adhesions using the catheter.
7. The procedure is repeated at 12 to 24-hour intervals over multiple days.
8. At each session, the provider performs a repeat epidural contrast injection to verify correct catheter placement and evaluate the surrounding epidural space.
9. Once the provider observes the gradual opening of constricted scar areas, the injections are complete, and the catheter is removed.
10. The wound is dressed with a sterile dressing.

4. Qualifying circumstances

CPT 62263 is performed on patients with epidural adhesions that require lysis. Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. The procedure is performed by a provider using solution injection or mechanical means, including radiologic localization. The sessions are conducted over multiple days.

5. When to use CPT code 62263

CPT code 62263 should be used when the provider performs percutaneous lysis of epidural adhesions using solution injection or mechanical means, including radiologic localization, over multiple sessions. This code is appropriate when the procedure is performed on two or more days.

6. Documentation requirements

To support a claim for CPT 62263, the provider must document the following information:

• Patient’s diagnosis and the need for percutaneous lysis of epidural adhesions
• Details of the procedure, including the use of solution injection or mechanical means
• Date and duration of each session
• Confirmation of correct catheter placement and evaluation of the epidural space using contrast
• Progress made in opening constricted scar areas
• Removal of the catheter and application of a sterile dressing

7. Billing guidelines

When billing for CPT 62263, ensure that the provider performs the procedure over multiple sessions and uses solution injection or mechanical means, including radiologic localization. It is important to follow the guidelines for reporting CPT code 62263 with other codes, if applicable.

8. Historical information

CPT 62263 was added to the Current Procedural Terminology system on January 1, 2000. There have been historical changes to the code, including a code change on January 1, 2003, which updated the description of the procedure.

9. Examples

1. A provider performing percutaneous lysis of epidural adhesions using solution injection over multiple sessions to relieve a patient’s chronic back pain.
2. A provider using mechanical means, including radiologic localization, to remove epidural adhesions in a patient with post-surgical complications.
3. A patient undergoing percutaneous lysis of epidural adhesions using solution injection over multiple sessions to alleviate symptoms of nerve compression.
4. A provider performing the procedure on a patient with epidural adhesions causing radiculopathy.
5. A patient receiving percutaneous lysis of epidural adhesions using mechanical means, including radiologic localization, to improve mobility and reduce pain.
6. A provider using solution injection to dissolve epidural adhesions in a patient with chronic spinal stenosis.
7. A patient undergoing percutaneous lysis of epidural adhesions using mechanical means over multiple sessions to address complications from a previous spinal surgery.
8. A provider performing the procedure on a patient with epidural adhesions causing neurological deficits.
9. A patient receiving percutaneous lysis of epidural adhesions using solution injection to alleviate symptoms of failed back surgery syndrome.