Neurology & Pain Management Coding Alert

Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. Would you code this at 62273?

Wyoming Subscriber

Answer: Code 62273 (Injection, epidural, of blood or clot patch) is not an appropriate choice for application of a piece of gelfoam to seal over an epidural tear. That’s because the physician typically uses an open surgical approach to insert the gelfoam as a dural repair rather than injection as indicated in the 62273 code descriptor. 

If you’re coding for an open approach to dural repair, options include 

• 63707 – Repair of dural/cerebrospinal fluid leak, not requiring laminectomy 
• 63709 – Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy.

If the physician completes the dural repair during another spinal procedure, it typically is included as part of the surgical procedure and not separately billable.