Does 62322 require prior authorization?

No, 62322 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 62322?

Medicare facility rate: $74.15. Non-facility rate: $145.63. Work RVU: 1.51.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

1.51

Facility

$74.15

Non-Facility

$145.63

All documentation supporting the service must be maintained in the patient's medical record, legible, include patient identifiers and dates of service, and be available to the contractor on request.
Every record page must include the legible signature of the physician or non-physician practitioner responsible for the care and signed dated office visit/operative reports for all services ordered or rendered.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Procedural reports for selective nerve root blocks (SNRBs) and TFESIs must document indications, medical necessity, and baseline pain score; SNRB reports must also document immediate percent pain relief achieved.

Epidural steroid injections (ESIs) for pain management are covered when reasonable and necessary per LCD L39015 and supported by the patient's medical record.
Epidural injection codes 62322-62327 used for cerebrospinal fluid flow imaging (cisternography, CPT 78630) are allowed and are exempt from the LCD diagnosis code restrictions when billed on the same claim.
Epidural injections (CPT 62321, 62323, 64479, 64480, 64483, 64484) used for postoperative pain management are allowed and exempt from the LCD diagnosis code restrictions.
Epidural injection CPT 62323 used as a trial for an implantable infusion pump is allowed and exempt from the LCD diagnosis code restrictions.
Diagnostic selective nerve root blocks (DSNRBs) are coded identically to epidural injections and are permitted when medically necessary; append the -KX modifier to distinguish DSNRBs from therapeutic epidurals.
Epidural steroid injections (epidural injections) are covered when reasonable and necessary per the associated Local Coverage Determination (LCD).

L39054 — Epidural Steroid Injections for Pain Management

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A58777 — Billing and Coding: Epidural Steroid Injections for Pain Management

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A58745 — Billing and Coding: Epidural Steroid Injections for Pain Management

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L39036 — Epidural Steroid Injections for Pain Management

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Ask Verity about documentation requirements, denial risks, or coverage in your state.