CPT® Code 22527

Add-On Code

Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (List separately in addition to code for primary procedure)

Percutaneous intradiscal electrothermal annuloplasty is a minimally invasive procedure designed to alleviate chronic low back pain associated with disc pathology. This technique involves the use of a catheter that is inserted into the intervertebral disc, specifically targeting the disc annulus or nucleus. The procedure begins with the identification of the affected disc through a process known as discography, which helps to pinpoint the source of pain. Once the target disc is located, a specialized spinal catheter equipped with a thermal resistive coil is carefully positioned within the disc. The catheter is maneuvered in a circuit-like fashion, passing through the disc and exiting posteriorly. During the procedure, electrothermal heat is generated via the coil, which heats the disc material to approximately 90 degrees centigrade for a duration of about 20 minutes. It is important to note that this heating process does not result in the destruction, burning, or ablation of the tissue. Instead, the application of heat is believed to provide pain relief by causing the collagen fibers within the disc to shrink and by thermocoagulating the adjacent nerve tissue or pain receptors. For coding purposes, CPT® Code 22526 is used for a single level of the procedure, while CPT® Code 22527 is designated for one or more additional levels, either unilaterally or bilaterally, performed in conjunction with the primary level. Fluoroscopic guidance is included as part of the procedure to ensure accurate placement of the catheter.