The March 2026 issue of CPT® Assistant provides additional guidance on reporting percutaneous spinal decompression procedures following changes made in the 2026 CPT® code set.

For 2026, CPT® added 62330 and 62331, revised 62287, and deleted Category III code 0275T. The guidance also helps distinguish percutaneous spinal procedures from endoscopic and open procedures.

When reviewing changes like these, coders should not rely on a single source. CPT® Assistant is one resource within the overall coding review process. The coder should consider all available resources that may provide applicable coding, coverage, documentation, or reporting guidance for the service being reviewed.

Depending on the procedure, payer, specialty, and circumstances of the encounter, this may include the current CPT® code set and guidelines, CPT® Assistant, NCCI edits and policy guidance, CMS publications, Medicare Administrative Contractor resources, commercial payer policies, specialty-society guidance, and other applicable procedure-specific resources.

The documentation should then be reviewed against the guidance identified through that research.

Start With the Approach and Visualization

One of the important distinctions addressed in the CPT® Assistant guidance is whether the procedure is percutaneous, endoscopic, or open.

For the procedures discussed in the article, a percutaneous spinal procedure uses indirect visualization, such as fluoroscopy or CT.

Endoscopic and open procedures involve direct visualization.

This distinction should be clearly supported in the operative report because the approach and visualization method can affect code selection.

Documentation that simply states:

“Lumbar decompression performed.”

does not provide enough information.

A more complete note might state:

“Percutaneous access was obtained at L3-L4. Fluoroscopic guidance was used throughout the procedure for indirect visualization. No endoscopic visualization was used.”

The coder can then compare that documentation with all available applicable guidance to determine the correct reporting pathway.

CPT® 62287: Needle-Based Lumbar Disc Decompression

Code 62287 describes percutaneous decompression of the nucleus pulposus of a lumbar intervertebral disc using a needle-based technique.

The procedure involves removal of disc material under fluoroscopic or other indirect visualization.

The documentation should identify the actual technique used rather than simply state that a lumbar decompression was performed.

Documentation Example

“Using fluoroscopic guidance, a needle-based percutaneous approach was advanced into the L4-L5 intervertebral disc. Disc material was removed through the needle-based decompression device to reduce pressure within the nucleus pulposus.”

If multiple lumbar levels are treated, each level should be identified.

For example:

“Needle-based percutaneous decompression of the nucleus pulposus was performed at L3-L4 and L4-L5 using fluoroscopic guidance.”

The coder should also review the CPT® instructions associated with the code to identify services that are included and determine whether any additional services may be separately reportable.

CPT® 62330: Percutaneous Lumbar Ligamentum Flavum Decompression

CPT® code 62330 describes a different type of percutaneous lumbar decompression.

This code represents bilateral percutaneous decompression with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and CT or fluoroscopic imaging guidance, at one lumbar interspace.

This is different from the needle-based disc decompression described by 62287.

The documentation should therefore identify:

• The structure being treated
• The spinal interspace
• The percutaneous approach
• The visualization method
• Whether the ligamentum flavum was partially removed
• Whether the procedure was performed bilaterally

Documentation Example

“Percutaneous interlaminar access was obtained at L3-L4 under fluoroscopic guidance. Epidurography was performed to establish baseline visualization. Portions of the lamina were removed for access, followed by partial removal and thinning of the ligamentum flavum. The procedure was completed bilaterally at L3-L4.”

A statement such as:

“MILD procedure performed at L3-L4.”

may not provide enough information by itself to confirm that all elements of the reported service were performed.

The coder should avoid relying only on a procedure or device name and should instead evaluate the documented procedural work.

Bilateral Versus Unilateral Documentation

Code 62330 describes a bilateral service.

If the procedure is not performed bilaterally, the coder should review the current CPT® guidance to determine the appropriate reporting method, including whether a reduced-service modifier is applicable.

The operative note needs to clearly identify laterality.

Bilateral Example

“Percutaneous decompression with partial removal of the ligamentum flavum was completed on both the right and left sides at L3-L4.”

Unilateral Example

“Percutaneous decompression with partial removal of the ligamentum flavum was performed on the right side only at L3-L4. No decompression was performed on the left.”

Clear documentation allows the coder to compare the service performed with the full code descriptor and applicable modifier guidance.

CPT® 62331: Additional Lumbar Interspace

Add-on code 62331 is used for an additional lumbar interspace when the applicable decompression service is performed beyond the initial interspace.

For example, the physician may perform treatment at L3-L4 and then repeat the procedure at L4-L5 during the same operative session.

Documentation Example

“Following completion of bilateral percutaneous decompression at L3-L4, the same technique was performed at the additional symptomatic L4-L5 interspace, including fluoroscopic guidance and bilateral partial removal of the ligamentum flavum.”

The operative report should clearly distinguish the initial interspace from any additional interspace treated.

When multiple levels are documented, the coder should review the current CPT® instructions, add-on code guidance, payer requirements, and applicable edits before determining how many units or codes may be reported.

Imaging Guidance

Imaging is an important part of these procedures, but documentation and separate reporting are two different questions.

The operative report should identify the imaging modality used.

For example:

“Fluoroscopy was used throughout the procedure to identify the interlaminar space, guide instrumentation, and assess the treated area.”

The coder should then review the applicable code descriptor and parenthetical instructions to determine whether the imaging is included in the primary procedure.

A service should not be separately reported simply because it appears in the operative note. The coder must determine whether it is already included in the primary CPT® service.

Epidurography

The same principle applies to epidurography.

Documentation may state:

“Contrast was injected through the epidural needle and epidurographic images were obtained before decompression. Repeat imaging was performed after the decompression to evaluate the treated area.”

The documentation tells us what was performed.

The coding guidance tells us whether that work is separately reportable or included in the primary service.

Both pieces are necessary.

Identify the Exact Spinal Region

The documentation should always identify the spinal region and specific interspace or level treated.

“Percutaneous spinal decompression” alone is not sufficient.

Compare:

“Percutaneous decompression performed at L3-L4.”

with:

“Percutaneous decompression performed at C6-C7.”

Those services involve different spinal regions and may lead the coder to different code families and different guidance.

The coder should use the clinical documentation to narrow the research question before selecting a code.

Do Not Assume Percutaneous, Endoscopic, and Open Mean the Same Thing

Procedure terminology is another area that deserves attention.

A procedure described clinically as a “decompression” may be performed through different approaches.

The operative report should identify how the physician accessed and visualized the operative site.

The coder should confirm whether the procedure was:

• Percutaneous
• Endoscopic
• Open

and whether visualization was:

• Indirect through fluoroscopy or CT
• Direct through an endoscope
• Direct through an open surgical approach

Those details can significantly change the coding pathway.

Documentation Review Points

For percutaneous spinal decompression services, I would review the operative report for:

• Spinal region
• Specific interspace or levels treated
• Percutaneous, endoscopic, or open approach
• Direct versus indirect visualization
• Needle-based versus non-needle-based technique
• Structure being decompressed
• Removal of ligamentum flavum when applicable
• Laminotomy performed for access when applicable
• Right, left, or bilateral treatment
• Fluoroscopy or CT guidance
• Epidurography when performed
• Initial and additional interspaces
• Other procedures performed during the same operative session

The documentation should allow the coder to understand what was actually performed without depending solely on a procedure name, device name, or templated statement.

Consider All Available Coding Resources

CPT® Assistant provides additional clarification, but it should be considered as one part of the full coding review.

The coder should consider all available resources that may provide applicable guidance for the service and payer being reviewed.

These resources may include:

• Current CPT® code descriptors and guidelines
• CPT® parenthetical instructions
• CPT® Assistant
• NCCI edits and policy guidance
• CMS publications
• Medicare Administrative Contractor guidance
• Commercial payer medical and reimbursement policies
• Specialty-society guidance
• Applicable procedure- or technology-specific resources
• Internal organizational coding and compliance policies
• The complete clinical documentation

Different resources may answer different questions.

CPT® guidance may help determine how a procedure is classified and reported. A payer policy may address coverage, medical necessity, prior authorization, frequency limitations, or reimbursement requirements. Specialty guidance may provide additional clinical or procedural context.

The goal is not simply to find a code that appears to match the name of the procedure.

The goal is to identify the coding question, review the available authoritative guidance, compare that guidance with the documentation, and determine which instructions apply to the specific service and payer.

For newer or revised procedures, that research process becomes even more important.

A coding decision should be based on the complete set of applicable guidance available for the service—not on a single resource viewed in isolation.

Source: Reporting Percutaneous Spinal Procedures (62287, 62330, 62331). CPT® Assistant, March 2026.

CPT® is a registered trademark of the American Medical Association. This article is intended for educational purposes. Coding decisions should be based on current applicable coding guidance, payer requirements, specialty guidance, and the documentation for the specific encounter.