Summary & Overview
CPT 62281: Cervical/Thoracic Epidural Neurolytic Injection
CPT code 62281 denotes an interventional pain-management procedure in which a neurolytic agent is injected or infused into the epidural space at the cervical or thoracic level, sometimes with an additional therapeutic drug. This procedure is used to provide durable pain relief in severe, acute, or cancer-related pain and following traumatic events such as limb amputation. Nationally, this code represents a specialized, high-acuity service often performed in hospital outpatient departments, ambulatory surgical centers, or other procedural settings equipped for epidural interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the service is used, comparisons of common payer coverage patterns, and benchmarks where available. The report summarizes coding and service-line considerations, typical settings of care, and relevant policy themes affecting access and payment for neurolytic epidural procedures. Data not available in the input are explicitly noted where applicable.
Billing Code Overview
CPT code 62281 describes the injection or infusion of a neurolytic agent into the epidural space at the cervical or thoracic spinal level. The service may include the concurrent administration of another therapeutic drug with the neurolytic. This procedure is intended to provide long-lasting interruption of nerve conduction to help eliminate severe pain after trauma or surgery (such as limb amputation) or to manage acutely painful conditions, including cancer-related pain.
Service type: Interventional pain management / neurolytic epidural injection
Typical site of service: Hospital outpatient department, ambulatory surgical center, or other procedural setting capable of epidural interventions
Data not available in the input for: payers beyond general list, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with advanced thoracic malignancy presents with severe, intractable chest and upper extremity pain despite opioid therapy and adjuvant analgesics. Pain intensity is severe, limits activities of daily living, and is poorly controlled with escalating systemic opioids. The interventional pain specialist evaluates the patient in the ambulatory surgical center or hospital interventional suite, reviews imaging (chest and cervical/thoracic MRI or CT), confirms focal epidural target at a cervical or thoracic level correlating with dermatomal pain, and discusses goals and risks of neurolytic epidural injection. After informed consent and sedation per facility protocols, the provider places the patient in the appropriate position, performs fluoroscopic or CT guidance, advances an epidural needle to the targeted cervical or thoracic epidural space, aspirates and administers contrast to confirm epidural spread, and injects a neurolytic agent (for example, phenol or alcohol) with or without an adjunctive therapeutic drug to achieve prolonged pain relief. The procedure may occur in an outpatient ambulatory surgical center, hospital operating room, or interventional radiology suite depending on patient comorbidity and monitoring needs. Post-procedure monitoring includes neurologic checks, hemodynamic observation, and discharge planning with clear documentation of pre-procedure pain, target level, agent used, volumes, fluoroscopic confirmation, immediate effect, and follow-up arrangements for oncology and palliative care coordination.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 |