Summary & Overview
CPT 62292: Chemonucleolysis of Lumbar Disc with Discography
CPT code 62292 represents chemonucleolysis of a lumbar intervertebral disc performed with fluoroscopic discography to localize the target. The procedure injects an enzyme into the nucleus pulposus to dissolve bulging disc material that compresses spinal nerves and relieves radicular back pain. Though less commonly used than surgical discectomy, chemonucleolysis remains clinically relevant where enzymatic dissolution is an appropriate, minimally invasive option.
Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and payer coverage considerations. The publication summarizes common modifiers and coding practice notes when available, outlines what benchmark data readers can expect to see, and highlights policy or coverage topics affecting utilization and reimbursement nationally.
This summary is intended to orient clinicians, coding professionals, and policy analysts to the clinical purpose of CPT code 62292, where the procedure is typically performed, and which major payers are relevant for coverage and claims considerations. Data not available in the input are noted where applicable in the full publication.
Billing Code Overview
CPT code 62292 describes a procedure known as chemonucleolysis with discography guidance. The provider injects an enzyme into a lumbar intervertebral disc to dissolve the bulging nucleus pulposus and relieve nerve compression. Fluoroscopic discography is performed to localize the affected disc and determine the precise injection site.
Service type: Therapeutic spinal procedure with diagnostic discography
Typical site of service: Hospital outpatient department or ambulatory surgery center; may also be performed in specialized interventional radiology or spine procedure suites
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with persistent unilateral low back pain radiating to the leg and sensory changes consistent with L4–L5 radiculopathy after conservative care (physical therapy, NSAIDs, and epidural steroid injection) failed over 6–12 weeks. Imaging (MRI) demonstrates a contained posterolateral lumbar disc herniation at L4–L5 with corresponding nerve root compression. The interventional spine physician schedules chemonucleolysis under fluoroscopic guidance to dissolve the nucleus pulposus and relieve nerve root impingement. In the procedural workflow the patient is positioned prone on the fluoroscopy table, sedation and local anesthesia are administered, and a diagnostic discography is performed to confirm the symptomatic disc level and annular disruption. Under live fluoroscopy the provider advances a spinal needle into the target disc, injects the chemonucleolytic enzyme, documents intradiscal contrast pattern, monitors for pain provocation, and completes the case with post-procedure observation. Typical site of service is an ambulatory surgery center or hospital outpatient department where fluoroscopy, sedation, and perioperative monitoring are available. Common patient considerations include allergy screening, coagulation status, and informed consent discussing risks such as infection, chemical radiculitis, or needle-related complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Increased procedural services | Use when the procedure required significantly greater resources than typically required (e.g., unusually complex access or prolonged fluoroscopy). |