How To Use CPT Code 62291

CPT 62291 describes the injection procedure for discography, specifically for the cervical or thoracic region of the spine. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 62291?

CPT 62291 is used to describe the injection procedure for discography in the cervical or thoracic region of the spine. This diagnostic procedure involves injecting contrast into the nucleus pulposus, the gel-like center of a spinal disc, to examine and visualize the intervertebral disc space. It is also known as a discogram or disc stimulation and is performed to identify damaged vertebrae causing neck or back pain.

2. Official Description

The official description of CPT code 62291 is: ‘Injection procedure for discography, each level; cervical or thoracic.’ This code specifically refers to the injection procedure for discography in the cervical or thoracic region of the spine. Please note that for radiological supervision and interpretation, different codes should be used (72285, 72295).

3. Procedure

1. The provider positions the patient on a radiolucent table, usually on one side and slightly forward.
2. She cleans the area for injection with an antiseptic and administers a local anesthetic to numb the skin and soft tissue overlying each disc.
3. Using fluoroscopic guidance, she carefully inserts a needle through the skin and muscle until it reaches the outer layer of the disc.
4. A second needle is passed through the first needle and inserted into the center of the suspect intervertebral disc.
5. Contrast is then injected through the needle and into the nucleus, or center, of the disc.
6. The provider takes images and evaluates the disc anatomy and dye pattern, looking for leaks outside of the disc.
7. She also assesses the patient’s response during and after each injection to determine the concordance of pain.
8. This process is repeated for each level necessary.
9. After completing the procedure, the provider applies a sterile dressing over the wound.

4. Qualifying circumstances

CPT 62291 is performed when there is a need to evaluate the discs of the cervical or thoracic spine using contrast and imaging. It is used to identify damaged vertebrae causing neck or back pain. The procedure is typically performed by a provider who specializes in spine and spinal cord procedures. It is important to note that this code specifically refers to the cervical or thoracic region and should not be used for other regions of the spine.

5. When to use CPT code 62291

CPT code 62291 should be used when performing an injection procedure for discography in the cervical or thoracic region of the spine. It is appropriate when there is a clinical need to evaluate the intervertebral discs in these specific regions using contrast and imaging. This code should not be used for other regions of the spine.

6. Documentation requirements

To support a claim for CPT 62291, the provider must document the following information:

• Patient’s diagnosis and the clinical need for discography
• Specific levels of the cervical or thoracic spine where the procedure was performed
• Date of the procedure
• Details of the injection procedure, including the use of contrast and imaging guidance
• Images obtained during the procedure
• Patient’s response to the injections and any observed leaks outside of the disc
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 62291, ensure that the procedure is performed in the cervical or thoracic region of the spine. It is important to report radiographic imaging separately if performed. Additionally, be aware of any specific payer guidelines or requirements for reporting this code. It is also important to note that CPT code 62291 should not be reported with codes 72285 or 72295, which are used for radiological supervision and interpretation.

8. Historical information

CPT 62291 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2007, with a revised description: ‘Injection procedure for diskography, each level; cervical or thoracic.’

9. Examples

1. A patient with chronic neck pain undergoes a discography procedure in the cervical region to identify the source of the pain.
2. A provider performs a discography procedure in the thoracic region of the spine for a patient experiencing persistent mid-back pain.
3. A discography procedure is performed in the cervical region for a patient with suspected disc herniation causing radiating arm pain.
4. A patient with a history of trauma undergoes a discography procedure in the thoracic region to evaluate for spinal instability.
5. A discography procedure is performed in the cervical region for a patient with suspected degenerative disc disease and persistent neck stiffness.
6. A provider performs a discography procedure in the thoracic region to evaluate for discogenic pain in a patient with a history of spinal surgery.
7. A patient with chronic neck pain and failed conservative treatment undergoes a discography procedure in the cervical region to determine the appropriate surgical intervention.
8. A discography procedure is performed in the thoracic region for a patient with suspected discitis causing persistent mid-back pain.
9. A provider performs a discography procedure in the cervical region for a patient with suspected discogenic headache.
10. A patient with chronic neck pain and previous negative imaging studies undergoes a discography procedure in the cervical region to further evaluate the cause of the pain.