CPT® Code 0629T

Official Description

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level

Common Language Description

The procedure described by CPT® Code 0629T involves the percutaneous injection of allogeneic cellular and/or tissue-based products into the intervertebral disc, specifically at the lumbar region. Allogeneic cells, often referred to as universal cells, are sourced from a single donor, such as umbilical cord blood, and are stored in a master cell bank. These cells are processed to meet the specific therapeutic needs of the patient. The use of allogeneic mesenchymal cells or tissue-based products, which may include materials like bone marrow or umbilical tissue, aims to address intervertebral disc degeneration. This method is designed to provide pain relief and enhance the quality of the disc without resorting to invasive surgical techniques. The procedure is performed under local anesthesia and utilizes imaging guidance, specifically computed tomography (CT), to ensure accurate placement of the injection. The injection is administered intradiscally, utilizing a ready-to-use material that contains a predetermined number of cells for each segment being treated. For billing purposes, CPT® Code 0629T is used to report the injection at the first level on one or both sides with CT guidance, while additional levels are reported using CPT® Code 0630T. This approach is considered more convenient compared to autologous cell therapy, as it eliminates the need for harvesting cells from the patient’s own body.

1. Indications

The percutaneous injection of allogeneic cellular and/or tissue-based products into the intervertebral disc is indicated for the treatment of intervertebral disc degeneration. This condition may present with symptoms such as chronic back pain, reduced mobility, and other related discomforts that affect the quality of life. The procedure aims to alleviate pain and improve the overall health of the intervertebral disc without the need for invasive surgical intervention.

Intervertebral Disc Degeneration Chronic back pain and reduced mobility due to degeneration of the intervertebral discs.

2. Procedure

The procedure begins with the patient being positioned appropriately to allow access to the lumbar region. Local anesthesia is administered to ensure the patient's comfort during the injection. Following this, imaging guidance, specifically computed tomography (CT), is utilized to accurately locate the intervertebral disc that requires treatment. The physician prepares a ready-to-use material containing allogeneic cells or tissue-based products, ensuring that the correct number of cells is included for the specific segment being injected. Once the target site is confirmed through imaging, the physician performs a percutaneous injection into the intervertebral disc. This injection can be done unilaterally or bilaterally, depending on the clinical need. The procedure is designed to be minimally invasive, allowing for a quicker recovery time compared to traditional surgical methods. After the injection is completed, the physician may monitor the patient briefly to ensure there are no immediate adverse reactions before discharging them for post-procedure care.

Step 1: Position the patient appropriately and administer local anesthesia to ensure comfort during the procedure.
Step 2: Utilize CT imaging to accurately locate the intervertebral disc targeted for injection.
Step 3: Prepare the ready-to-use material containing allogeneic cells or tissue-based products, ensuring the correct dosage for the segment.
Step 4: Perform the percutaneous injection into the intervertebral disc, which can be done on one or both sides as clinically indicated.
Step 5: Monitor the patient post-injection for any immediate adverse reactions before discharge.

3. Post-Procedure

After the procedure, patients are typically monitored for a short period to assess for any immediate complications or adverse reactions. It is common for patients to experience some discomfort at the injection site, which may be managed with over-the-counter pain relief medications. Patients are usually advised to avoid strenuous activities for a short period to allow for proper healing. Follow-up appointments may be scheduled to evaluate the effectiveness of the treatment and to monitor the patient's recovery progress. Additional considerations may include physical therapy or other supportive measures to enhance recovery and improve functional outcomes.

Short Descr	PERQ NJX ALGC CT LMBR 1ST
Medium Descr	PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR 1ST
Long Descr	Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	2 - 150% payment adjustment does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator	Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Berenson-Eggers TOS (BETOS)	none
MUE	1

This is a primary code that can be used with these additional add-on codes.

0630T

Add-on Code MPFS Status: Carrier Priced APC N ASC N1 Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure)