How To Use CPT Code 62292

CPT 62292 describes the injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar. 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 62292?

CPT 62292 can be used to describe the injection procedure for chemonucleolysis, specifically targeting the intervertebral disc in the lumbar region. This code is used when a provider injects an enzyme into the disc to dissolve the bulging nucleus pulposus, relieving back pain caused by pressure on the spinal nerve.

2. Official Description

The official description of CPT code 62292 is: ‘Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar.’

3. Procedure

1. The provider positions the patient on a radiolucent table and cleans the skin over the area for injection.
2. A local anesthetic is injected to numb the skin and soft tissue overlying the lumbar levels.
3. Using fluoroscopic guidance, the provider carefully guides a needle through the skin and muscle and into the center of the intervertebral disc.
4. Saline or water is injected to verify correct needle placement in the nucleus of the disc.
5. Contrast is injected to ensure that the disc is only bulging and not ruptured.
6. If the disc is bulging and intact, the provider proceeds with the procedure.
7. A small test dose of the enzyme is injected to check for any allergic reactions.
8. The full dose of chymopapain, the enzyme, is then injected into the disc.
9. The needle is removed, and the procedure is repeated for each level necessary.
10. A sterile dressing is applied to the injection site.

4. Qualifying circumstances

CPT 62292 is performed on patients with a herniated disc causing back pain due to pressure on the spinal nerve. The procedure involves injecting an enzyme into the lumbar intervertebral disc to dissolve the bulging nucleus pulposus. It is important to note that this procedure is specific to the lumbar region and should not be used for other areas of the spine.

5. When to use CPT code 62292

CPT code 62292 should be used when a provider performs the injection procedure for chemonucleolysis on the lumbar intervertebral disc. It is important to ensure that the procedure is performed specifically for the treatment of a herniated disc and that the provider follows the appropriate steps outlined in the official description.

6. Documentation requirements

To support a claim for CPT code 62292, the provider must document the following information:

• Patient’s diagnosis of a herniated disc and the need for chemonucleolysis
• Specific lumbar levels targeted for the injection
• Date of the procedure
• Start and end time of the procedure
• Injection technique used, including the use of fluoroscopy for guidance
• Confirmation of correct needle placement and absence of disc rupture
• Details of the enzyme injection, including any test doses administered
• Number of levels treated
• Any complications or adverse reactions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 62292, ensure that the procedure is performed specifically for chemonucleolysis of the lumbar intervertebral disc. It is important to follow the appropriate documentation requirements and guidelines for accurate billing. Report radiographic imaging and saline acceptance testing separately. It is also important to note that CPT code 62292 should not be reported with other codes related to different procedures or regions of the spine.

8. Historical information

CPT code 62292 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performing chemonucleolysis on a single lumbar intervertebral disc to treat a herniated disc causing back pain.
2. A patient undergoing the injection procedure for chemonucleolysis on multiple lumbar levels to relieve pressure on the spinal nerve.
3. A provider using fluoroscopy to guide the injection of an enzyme into a bulging lumbar disc, targeting the nucleus pulposus.
4. A patient receiving chemonucleolysis for a herniated disc in the lumbar region, resulting in the shrinkage of the bulging disc and alleviation of back pain.
5. A provider performing the injection procedure for chemonucleolysis on a single lumbar level, using a test dose of the enzyme to ensure the absence of allergic reactions.
6. A patient undergoing chemonucleolysis on multiple lumbar levels, with the full dose of chymopapain injected into each disc to dissolve the bulging nucleus pulposus.
7. A provider documenting the details of the injection procedure for chemonucleolysis, including the specific lumbar levels treated and the confirmation of correct needle placement.
8. A patient experiencing relief from back pain after undergoing chemonucleolysis on a single lumbar intervertebral disc.
9. A provider performing the injection procedure for chemonucleolysis on multiple lumbar levels, resulting in the reduction of pressure on the spinal nerve and improvement in the patient’s symptoms.
10. A patient receiving chemonucleolysis for a herniated disc in the lumbar region, with the enzyme injection successfully dissolving the bulging nucleus pulposus and relieving back pain.