Summary & Overview
CPT 0629T: CT-Guided Cellular or Tissue-Based Injection Into Lumbar Disc
CPT code 0629T identifies a CT-guided injection of a cellular or tissue–based product into a lumbar intervertebral disc for the first level treated. This emerging interventional procedure is notable nationally as biologic and regenerative spinal therapies expand, creating new coverage, coding, and utilization considerations across major payers. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what the code represents, payer coverage patterns, and the clinical context for use of CT guidance and lumbar disc targeting. The publication outlines common billing modifiers and service-line placement, explains typical sites of service, and summarizes benchmarks and reimbursement policy trends affecting adoption and coverage decisions. It also highlights operational considerations for coding the first disc level treated and how bilateral vs unilateral injections are represented under this code.
Data not available in the input is noted where specific payer policy details, associated taxonomies, ICD-10 diagnoses, and related codes would normally be provided. The focus remains on national implications for payers and providers considering CT-guided cellular or tissue–based lumbar disc injections.
Billing Code Overview
CPT code 0629T describes the injection of a cellular or tissue–based product into a lumbar intervertebral disc performed under computed tomography (CT) guidance. The code applies to the first lumbar disc level injected, and the injection may be administered on one side or both.
-
Service type: Image-guided therapeutic injection of a biologic cellular or tissue–based product into the lumbar disc
-
Typical site of service: Hospital outpatient department or ambulatory surgery/procedure center where CT-guided interventional procedures are performed
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient with chronic axial low back pain and focal radicular symptoms presents after failing conservative care including physical therapy, nonsteroidal anti-inflammatory drugs, and targeted epidural steroid injections. MRI demonstrates a symptomatic degenerative lumbar intervertebral disc at the L4-L5 level with preserved disc height but focal annular disruption and concordant pain on provocative discography. The interventional spine team plans a minimally invasive biologic injection under computed tomography guidance using a cellular or tissue–based product to promote disc healing and reduce pain. The procedure is performed in an outpatient interventional radiology or ambulatory surgery center equipped with CT imaging.
The clinical workflow includes pre-procedure evaluation and informed consent, verification of indication and prior conservative therapies, sterile preparation and local/regional anesthesia, CT-guided localization of the target disc, percutaneous transforaminal or posterolateral approach to the symptomatic disc nucleus, delivery of the cellular or tissue–based product into the disc, immediate post-procedure CT confirmation, recovery monitoring for vital signs and neurologic status, and discharge with specific activity restrictions and follow-up arranged with the spine clinic.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds usual for the procedure due to complex anatomy or additional intra-procedural tasks. |
23 | Unusual anesthesia | Use if the procedure required general anesthesia or deep sedation for medically necessary reasons when the code usually is performed with local anesthesia. |
51 | Multiple procedures | Use when another distinct procedure is reported the same day in addition to the primary CT-guided disc injection. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use if the procedure is started but terminated due to extenuating circumstances or patient safety concerns. |
62 | Two surgeons | Use when two surgeons from different specialties work together as primary surgeons for a portion of the procedure. |
66 | Surgical team | Use when a surgical team (multiple surgeons with defined roles) is necessary for the procedure. |
73 | Discontinued outpatient before anesthesia | Use if the outpatient procedure is discontinued prior to anesthesia administration. |
78 | Unplanned return to OR | Use when a return to the operating room for a related procedure occurs during the postoperative period. |
80 | Assistant surgeon | Use when an assistant surgeon is required and documented. |
81 | Minimum assistant surgeon | Use when a qualified individual provides limited assistance as documented. |
82 | Assistant not available | Use when an assistant surgeon is not available and another qualified individual provides assistance. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | Use when services are furnished by an assistant-level practitioner where allowed. |
QX | Anesthesia services by CRNA with physician not present | Use when a certified registered nurse anesthetist provides anesthesia without the supervising physician present, if anesthesia is billed. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2084P0800X | Physical Medicine & Rehabilitation | Clinicians who manage nonoperative spine care and regenerative disc interventions. |
207X00000X | Physical Medicine & Rehabilitation (Physician) | Physicians specializing in interventional spine procedures and pain management. |
2086S0102X | Interventional Pain Medicine | Pain medicine specialists who perform image-guided disc interventions. |
208500000X | Physical Medicine & Rehabilitation (Physician Assistant) | Advanced practice providers who assist in pre- and post-procedure care. |
364S00000X | Interventional Radiology | Radiologists who perform CT-guided percutaneous spinal procedures. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M51.26 | Other intervertebral disc displacement, lumbar region | Common cause of focal discogenic pain targeted by intradiscal biologic injections. |
M51.36 | Other intervertebral disc degeneration, lumbar region | Degenerative disc disease often associated with chronic low back pain treated with regenerative intradiscal therapies. |
M51.37 | Intervertebral disc disorder, lumbar region, unspecified | Used when specific degenerative or displacement terminology is not fully specified but disc pathology is present. |
M54.16 | Radiculopathy, lumbar region | Radicular symptoms referable to a lumbar disc that may improve after targeted intradiscal treatment. |
M54.5 | Low back pain | General presenting symptom that may lead to evaluation and consideration of intradiscal biologic injection. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
62287 | Injection, including indwelling catheter, of contrast for lumbar discography, single level | Performed pre-procedure when diagnostic discography is used to confirm symptomatic disc concordance prior to biologic injection. |
76942 | Ultrasonic guidance for needle placement (e.g., imaging guidance) | May be used when ultrasound adjunct or alternative imaging guidance is applied for needle localization; CT guidance remains primary for 0629T. |
77012 | CT guidance for biopsy, aspiration and/or localization procedures (e.g., for structural guidance) | Represents CT guidance codes used to report imaging supervision and interpretation when CT localization is separately billable alongside the injection. |
99152 | Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes) | Used when moderate sedation is provided by the physician performing the procedure; sedation may be required for patient comfort during CT-guided injection. |
99153 | Each additional 15 minutes of physician time for moderate sedation | Used with 99152 when additional sedation time is documented beyond the initial period. |
99072 | Additional supplies, materials, and clinical staff time due to COVID-19 or other special circumstances | Used when additional documented supplies or precautions are required; apply per payer rules. |