Summary & Overview
CPT 62291: Discography (Discogram) for Cervical or Thoracic Discs
CPT code 62291 denotes diagnostic discography — a targeted contrast injection into the nucleus pulposus to visualize intervertebral disc anatomy and stimulate the disc to localize pain generators in the cervical or thoracic spine. The code is used when clinicians seek to confirm discogenic sources of neck or upper back pain and when imaging and clinical exams alone are insufficient. Nationally, discography remains a specialized diagnostic tool with implications for surgical planning and pain management pathways.
This publication covers major payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, the typical sites of service where discography is performed, and an overview of what to expect in payer coverage and coding practice. The report highlights benchmarking considerations, common billing modifiers encountered in practice, and how CPT code 62291 fits into care pathways for suspected discogenic pain.
The material is intended for billing professionals, clinicians involved in spine care, and policy analysts seeking clarity on coding, clinical use, and payer interactions related to discography.
Billing Code Overview
CPT code 62291 describes a diagnostic discography procedure in which contrast is injected into the nucleus pulposus (the gel-like center) of an intervertebral disc to visualize the disc space and help identify painful or damaged cervical or thoracic discs. Also called a discogram or disc stimulation, the procedure is used to evaluate suspected discogenic neck or back pain.
-
Service type: Diagnostic spinal injection procedure (discography)
-
Typical site of service: Outpatient surgical center or hospital outpatient department; may also be performed in an ambulatory surgery center or specialized imaging suite
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with chronic axial low back pain and intermittent radicular symptoms refractory to conservative care (physical therapy, NSAIDs, epidural steroid injections) is referred to a spine specialist for diagnostic evaluation. After MRI reveals multilevel degenerative changes without clear correlation to symptoms, the provider recommends provocation discography to identify symptomatic intervertebral disc(s). The procedure is scheduled in an outpatient ambulatory surgery center under conscious sedation or monitored anesthesia care. Under fluoroscopic guidance, contrast is injected into the nucleus pulposus of target lumbar discs to reproduce the patient’s typical pain and assess internal disc architecture. Post-procedure, the patient is observed in recovery for hemodynamic stability and monitored for neurological changes and contrast reaction before discharge with post-procedure analgesia and activity instructions. Documentation includes informed consent, indication, targeted levels, needle approach and size, volumes and pressures used, fluoroscopic images, pain provocation responses, any complications, and plan for surgical or conservative management based on findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing physician/provider bills only interpretation and professional work separate from facility or technical component |