How To Use CPT Code 62287

CPT 62287 describes a percutaneous decompression procedure of the nucleus pulposus of an intervertebral disc in the lumbar region of the spine. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62287?

CPT 62287 is used to describe a percutaneous decompression procedure of the nucleus pulposus of an intervertebral disc in the lumbar region of the spine. This procedure involves the removal of a small amount of the gel-like substance in the middle of the disc, known as the nucleus pulposus, to relieve pressure on the nerves of the spine. The provider uses a needle-based technique under fluoroscopic imaging or other forms of indirect visualization to remove the disc material. The procedure may also include discography and/or epidural injections at the treated level(s).

2. Official Description

The official description of CPT code 62287 is: ‘Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar.’

3. Procedure

1. The provider begins by making a needle puncture through the skin and into the disc interspace in the lumbar region of the spine.
2. Using fluoroscopic imaging or other forms of indirect visualization, the provider confirms the proper positioning of the needle.
3. The provider then aspirates a small amount of disc material, removing it between two vertebrae to decompress the nerve.
4. If necessary, the procedure may also include discography, which involves injecting contrast into the disc to better visualize the disc and protruding material.
5. Epidural injections may also be performed at the treated level(s) for analgesic or pain relief purposes.

4. Qualifying circumstances

CPT 62287 is performed on patients with a protruding disc in the lumbar region of the spine that is causing nerve compression and related symptoms. The procedure is suitable for patients who have not responded to conservative treatments and require decompression of the nucleus pulposus. It is important to note that CPT 62287 should not be reported in conjunction with codes 62267, 62290, 62322, 77003, 77012, or 72295 when performed at the same level.

5. When to use CPT code 62287

CPT code 62287 should be used when a provider performs a percutaneous decompression procedure of the nucleus pulposus of an intervertebral disc in the lumbar region of the spine. This code is appropriate for single or multiple levels and when discography and/or epidural injections are performed at the treated level(s).

6. Documentation requirements

To support a claim for CPT 62287, the provider must document the following information:

• Patient’s diagnosis and the need for decompression of the nucleus pulposus
• Details of the procedure, including the method utilized, fluoroscopic imaging or other forms of indirect visualization, and the use of discography and/or epidural injections
• Date and duration of the procedure
• Specific levels treated
• Progress made by the patient and any additional treatments planned
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62287, it is important to ensure that the procedure meets the criteria outlined in the official description. The provider should not report CPT 62287 in conjunction with codes 62267, 62290, 62322, 77003, 77012, or 72295 when performed at the same level. It is also important to note that fluoroscopic guidance is included in code 62287 and should not be reported separately. Additional tips for accurate billing may be provided by the payer or coding guidelines.

8. Historical information

CPT 62287 was added to the Current Procedural Terminology system on January 1, 1991. Since its addition, there have been several changes to the code, including updates to the description and the addition of discography and/or epidural injections as qualifying circumstances.

9. Examples

1. A patient with a protruding lumbar disc undergoes a percutaneous decompression procedure of the nucleus pulposus using a needle-based technique under fluoroscopic imaging. Discography and epidural injections are performed at the treated level(s) to provide additional visualization and pain relief.
2. A provider performs a percutaneous decompression procedure of the nucleus pulposus on multiple levels of the lumbar spine for a patient with severe nerve compression. The procedure includes fluoroscopic imaging, discography, and epidural injections at each treated level.
3. Using a needle-based technique and fluoroscopic imaging, a provider performs a percutaneous decompression procedure of the nucleus pulposus on a single level of the lumbar spine. Discography is performed to visualize the disc and guide the removal of the protruding material.
4. A patient with persistent back pain undergoes a percutaneous decompression procedure of the nucleus pulposus in the lumbar region of the spine. The procedure includes fluoroscopic imaging, discography, and epidural injections to provide pain relief and improve mobility.