Lumbar puncture Procedure code and Description
62270 T Spinal puncture, lumbar, diagnostic 0206 $373 $204
62272 T Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) 0206 $373 $204
62273 T Injection, epidural, of blood or clot patch 0207 $672 $368
What is a Lumbar Puncture?
Fluoroscopy is a special form of X-ray that produces real-time video images, as opposed to pictures on film, making it possible to see internal organs and joints in motion. A lumbar puncture (also called a spinal tap) is a fluoroscopic procedure used to collect and look at the cerebrospinal fluid (CSF) surrounding the brain and spinal cord.
A lumbar puncture can help diagnose serious infections, such as
• Meningitis;
• Other disorders of the central nervous system, such as Guillain-Barre syndrome and multiple sclerosis;
• Cancers of the brain or spinal cord.
Sometimes doctors use lumbar puncture to inject anesthetic medications or chemotherapy drugs into the cerebrospinal fluid.
Other names for a lumbar puncture (an LP):
• Spinal tap
• Spinal puncture
• Thecal puncture (thecal sac is a membrane of dura mater that surrounds the spinal cord and the cauda equina)
• Rachiocentesis (prefix “rachio-” indicating “spine”)
Other spinal punctures or punctures to obtain cerebral spinal fluid (CSF):
• Ventricular puncture (this is a puncture into a lateral ventricle of the brain)
• Cisternal puncture (this is a cervical vertebral puncture into the cisterna at the base of the brain)
Spinal Injection Procedures that May Be Done Without Fluoroscopy Interlaminar epidural steroid injections may be performed without fluoroscopy if performed at a certified or accredited facility by a provider with privileges to perform the procedure at that facility. The provider must decide whether to use fluoroscopy based on sound medical practice. To be payable, these spinal injections must include a facility place of service code and documentation that the procedure was performed at a certified or accredited facility. Procedure Code 62310 62311 62318 62319
Spinal Injection Procedures that Don’t Require Fluoroscopy Procedure Code 62270 62272 62273
Anesthesia Service Codes not an all-inclusive list
Procedure Code - 00100 to 00936, 00940 to 01999, 62273, 99100 to 99150
HCPCS Code - D9220, D9221 (D-codes only covered for oral surgery)
Anesthesia Modifiers *not an all-inclusive list. See Modifier policy for a complete list Modifiers must be billed with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed or medically supervised.
Service will deny:
* When billed without appropriate modifier for provider’s specialty
* When modifier is not billed in the appropriate modifier position.
* When billed with invalid modifier combinations. (see incorrect modifier billing combination grid below)
* If not billed in accordance with standard coding/billing guidelines and Neighborhood’s policies
Image Guidance: 77003 Fluoroscopy Image Guidance: Guidance: 77003 Fluoroscopy Fluoroscopy * Spine and Spinal Cord: Injection, Drainage, or Aspiration Procedure Section Guidelines
– Injection of contrast during fluoroscopic guidance and localization is an inclusive component in 62263, 62264, 66267, 62270-62273, 62280-62282, 62310- 62319.
A second issue relates to the reimbursement schedule. Most of the interventional procedures are grouped into Group II, diagnostic and therapeutic procedures with therapeutic procedures being reimbwsed at 7 5o/o of the applicable group rates of $130.00 and other diagnostic procedures at $168.00.
The following procedures are either listed in Group II C or D:
Procedure 62273 - injection, epidural, ofblood or clot patch
Procedure 62281 - injection/infusion of neurolytic substance, with or without other therapeutic substance; epidural, cervical or thoracic
Procedure 62282 - injection/infusion of neurolytic substance, with or without other therapeutic substance; epidural, lumbar, sacral (caudal)
Procedure 6231,0 - injection, single, not including neurolytic substances, with or without contrast, of diagnostic or'therapeutic substances; epidural or subarachnoid; cervical or thoracic
Procedure 62311 - - injection, single, not including neurolytic substances, with or without contrast, of diagnostic or therapeutic substances; epidural or subarachnoid; lumbar, sacral (caudal)
62270 T Spinal puncture, lumbar, diagnostic 0206 $373 $204
62272 T Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) 0206 $373 $204
62273 T Injection, epidural, of blood or clot patch 0207 $672 $368
What is a Lumbar Puncture?
Fluoroscopy is a special form of X-ray that produces real-time video images, as opposed to pictures on film, making it possible to see internal organs and joints in motion. A lumbar puncture (also called a spinal tap) is a fluoroscopic procedure used to collect and look at the cerebrospinal fluid (CSF) surrounding the brain and spinal cord.
A lumbar puncture can help diagnose serious infections, such as
• Meningitis;
• Other disorders of the central nervous system, such as Guillain-Barre syndrome and multiple sclerosis;
• Cancers of the brain or spinal cord.
Sometimes doctors use lumbar puncture to inject anesthetic medications or chemotherapy drugs into the cerebrospinal fluid.
Other names for a lumbar puncture (an LP):
• Spinal tap
• Spinal puncture
• Thecal puncture (thecal sac is a membrane of dura mater that surrounds the spinal cord and the cauda equina)
• Rachiocentesis (prefix “rachio-” indicating “spine”)
Other spinal punctures or punctures to obtain cerebral spinal fluid (CSF):
• Ventricular puncture (this is a puncture into a lateral ventricle of the brain)
• Cisternal puncture (this is a cervical vertebral puncture into the cisterna at the base of the brain)
Spinal Injection Procedures that May Be Done Without Fluoroscopy Interlaminar epidural steroid injections may be performed without fluoroscopy if performed at a certified or accredited facility by a provider with privileges to perform the procedure at that facility. The provider must decide whether to use fluoroscopy based on sound medical practice. To be payable, these spinal injections must include a facility place of service code and documentation that the procedure was performed at a certified or accredited facility. Procedure Code 62310 62311 62318 62319
Spinal Injection Procedures that Don’t Require Fluoroscopy Procedure Code 62270 62272 62273
Anesthesia Service Codes not an all-inclusive list
Procedure Code - 00100 to 00936, 00940 to 01999, 62273, 99100 to 99150
HCPCS Code - D9220, D9221 (D-codes only covered for oral surgery)
Anesthesia Modifiers *not an all-inclusive list. See Modifier policy for a complete list Modifiers must be billed with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed or medically supervised.
Service will deny:
* When billed without appropriate modifier for provider’s specialty
* When modifier is not billed in the appropriate modifier position.
* When billed with invalid modifier combinations. (see incorrect modifier billing combination grid below)
* If not billed in accordance with standard coding/billing guidelines and Neighborhood’s policies
Image Guidance: 77003 Fluoroscopy Image Guidance: Guidance: 77003 Fluoroscopy Fluoroscopy * Spine and Spinal Cord: Injection, Drainage, or Aspiration Procedure Section Guidelines
– Injection of contrast during fluoroscopic guidance and localization is an inclusive component in 62263, 62264, 66267, 62270-62273, 62280-62282, 62310- 62319.
A second issue relates to the reimbursement schedule. Most of the interventional procedures are grouped into Group II, diagnostic and therapeutic procedures with therapeutic procedures being reimbwsed at 7 5o/o of the applicable group rates of $130.00 and other diagnostic procedures at $168.00.
The following procedures are either listed in Group II C or D:
Procedure 62273 - injection, epidural, ofblood or clot patch
Procedure 62281 - injection/infusion of neurolytic substance, with or without other therapeutic substance; epidural, cervical or thoracic
Procedure 62282 - injection/infusion of neurolytic substance, with or without other therapeutic substance; epidural, lumbar, sacral (caudal)
Procedure 6231,0 - injection, single, not including neurolytic substances, with or without contrast, of diagnostic or'therapeutic substances; epidural or subarachnoid; cervical or thoracic
Procedure 62311 - - injection, single, not including neurolytic substances, with or without contrast, of diagnostic or therapeutic substances; epidural or subarachnoid; lumbar, sacral (caudal)