CPT® Code 62264

Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day

The procedure described by CPT® Code 62264 involves the percutaneous lysis of epidural adhesions, which are fibrous bands of scar tissue that can form in the epidural space and may contribute to pain or neurological symptoms. This procedure utilizes the injection of one or more substances, such as hypertonic saline or enzymes, to break down these adhesions. The process begins with the preparation of the skin over the injection site, which includes cleansing and the administration of a local anesthetic to minimize discomfort. Radiologic guidance, typically fluoroscopy, is employed to accurately position a spinal needle into the epidural or caudal vertebral space at the targeted vertebral level. Once the needle is in place, a catheter is threaded through it into the epidural space, allowing for the delivery of therapeutic agents directly to the site of adhesion. The use of contrast material is crucial as it helps confirm the correct placement of the catheter and allows for the assessment of the surrounding nerve roots and spinal nerves. The procedure may involve multiple injections, with substances such as hyaluronidase, local anesthetics, and steroids being administered to facilitate the lysis of adhesions. The timing and sequence of these injections are carefully planned, with contrast being used to verify catheter positioning before each injection. This meticulous approach aims to ensure the effective treatment of the adhesions while monitoring the condition of the epidural space and the target nerves. CPT® Code 62264 is specifically used when these injections are performed within a single day, distinguishing it from similar procedures that may span multiple days.