CPT 62270, CPT 62272, CPT 62273, CPT code 62270, CPT code 62272, CPT code 62273, 62270 cpt code, 62272 cpt code, 62273 cpt code

CPT 62270, CPT 62272 & CPT 62273 | Billing Guide For Lumbar Puncture

Lumbar puncture procedures can be reported with CPT 62270, CPT 62272 and CPT 62273. We explain a lumbar puncture procedure and the CPT codes with billing guidelines.

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  1. What Is Lumbar Puncture?
  2. CPT 62270
    1. Procedure
    2. Billing Guidelines
  3. CPT 62272
    1. Procedure
    2. Billing Guidelines
  4. CPT 62273
    1. Procedure
    2. Billing Guidelines

1. What Is 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.

Procedures described by the .umbar puncture CPT codes can help diagnose serious infections, such as;

  • cancers of the brain or spinal cord;
  • meningitis; or
  • Disorders of the central nervous system (for example, multiple sclerosis and Guillain-Barre syndrome.

Lumbar puncture is sometimes used to inject chemotherapy drugs or anesthetic medications into the cerebrospinal fluid.

1. CPT 62270

CPT code 62270 is described by the CPT manual as: “Spinal puncture, lumbar, diagnostic.”

1.1 Procedure

The goal of the diagnostic procedure described by 62270 CPT code is to obtains a sample of the cerebrospinal fluid (CSF) for examination.

After the patient is anesthetized and properly prepped, the health provider identifies and marks the space between the third or third and fourth lumbar vertebrae with a surgical marker.

A needle is inserted into the spine to avoid injury to blood vessels nearby. The provider advances the needle until CSF leaks out. Then, the surgeon collects between 8 and 15 mL of CSF. This is send to pathology for examination and analysis.

The provider flushes the site with saline and applies a gauze. If this procedure fails, the health provider performs it again ut this time under fluoroscopic guidance. Obese patients have the highest risk of a repeated procedure.

1.2 Billing Guidelines

The procedure described by CPT 62270 is most commonly performed at L2 to L3 level or L3 to L4 level of the lumbar spine.

For diagnostic lumbar puncture, report CPT 62270 and CPT 62272 can be reported for therapeutic spinal punctures.

Do not bill these codes if the health provider uses imaging guidance during the procedure.

Report CPT code 62326 for diagnostic lumbar spinal puncture with fluoroscopic or CT guidance and CPT code 62329 can be billed for therapeutic spinal puncture by catheter or needle with CT or fluoroscopic guidance to drain cerebrospinal fluid.

2. CPT 62272

CPT code 62272 is described by the CPT manual as: “Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter).”

2.1 Procedure

The goal of the procedure described by 62272 CPT code is to insert a hollow catheter or needle or into the subarachnoid space to withdraw CSF. This procedure is often called a spinal tap.

In this procedure, the provider positions the patient on his or her side with knees pulled up to the chest, or sitting, leaning forward on a stable surface.

After prepping and draping the patient, the provider administers a local anesthetic at the proposed puncture site, first infiltrating the skin and then deeper tissue.

This area usually corresponds with the fourth and fifth lumbar space. She then inserts a needle between the two vertebrae, through the dura, and into the fluid–filled spinal canal.

When fluid returns through the needle, the provider may attach a manometer, a special tube that attaches to the needle to measure the pressure of the CSF.

The provider then may withdraw the fluid through the needle, or she may insert a catheter to siphon CSF, or she may allow it to drip out of the needle on its own and collect a small amount, about one tablespoon, in test tubes.

In any case, she collects the fluid and sends it to the laboratory for testing. Finally, she withdraws the needle and applies a sterile dressing.

After the procedure, the provider may have the patient continue to lie flat to reduce the incidence of a headache by not elevating his head or prevent leakage of fluid.

2.2 Billing Guidelines

The procedure described by CPT 62272 is most commonly performed at L2 to L3 level or L3 to L4 level of the lumbar spine.

CPT code 62272 can be billed for therapeutic spinal punctures and CPT code 62270 for diagnostic lumbar puncture.

3. CPT 62273

CPT code 62273 is described by the CPT manual as: “Injection, epidural, of blood or clot patch.”

3.1 Procedure

The goal of the procedure described by 62273 CPT code is to treat a post spinal headache that is caused by an hole or tear in the dura from a spinal needle, epidural, or lumbar puncture.

In this procedure, an anesthesia provider typically administers a blood patch to seal a spinal fluid leak.

The provider positions the patient on his or her side with knees pulled up to the chest, or sitting, leaning forward on a stable surface.

The provider cleans the area with an antiseptic solution and numbs it with a local anesthetic. Next, he inserts a needle into the patient’s arm and withdraws a small amount of blood.

Then the provider injects the blood into the epidural space at the level of the leak in the same space or right next to the area where he injected the anesthetic to clot and seal the hole in the dura.

He does this in a procedure similar to the original spinal injection or epidural that caused the leak.

Then he withdraws the needle and applies a sterile dressing. He has the patient lay flat for a period of time and then slowly raises the patient’s head to a sitting position.

3.2 Billing Guidelines

Report CPT 62273 for diagnostic purposes or therapeutic substances. Report otherwise, CPT 62320, CPT 62321, CPT 62322, CPT 62323, CPT 62324, CPT 62325, CPT 62326 or CPT 62327.

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