CPT® Code 62292

Chemonucleolysis is a minimally invasive procedure aimed at treating herniated nucleus pulposus, commonly known as a herniated disc. This condition occurs when the gelatinous center of the intervertebral disc, called the nucleus pulposus, bulges or ruptures, leading to pain and discomfort. The procedure involves the injection of an enzyme called chymopapain directly into the affected disc. Chymopapain works by dissolving the gelatinous material, thereby reducing pressure on surrounding nerves and alleviating pain. The patient is typically positioned on their side to facilitate access to the lumbar region of the spine. Prior to the injection, the skin over the injection site is thoroughly cleansed with an antiseptic solution to minimize the risk of infection. A local anesthetic is administered to ensure the patient remains comfortable during the procedure. The use of fluoroscopic guidance is essential for accurately positioning the needle within the disc. This technique allows the physician to visualize the needle's placement in real-time, ensuring precision and safety. The procedure may involve the injection of saline or contrast material to confirm the correct disc is targeted, and the patient's response is monitored closely to assess for any hypersensitivity to the enzyme. If the initial test dose is well-tolerated, a full therapeutic dose of chymopapain is then administered, which may be repeated for multiple affected discs if necessary.