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What documentation is required for a Lumbar Puncture?
CPT does not provide specific documentation requirements for a Lumbar Puncture. The medical record should clearly indicate that the procedure was performed and identify the performing clinician.
What are the CPT codes for lumbar puncture?
Lumbar puncture is coded with either:
If fluoroscopic or CT guidance are used, different CPT codes apply.
What if I use ultrasound guidance to perform a lumbar puncture?
Ultrasound guidance for LP can be coded with:
As with all ultrasound codes, the CPT code descriptor requires permanent recording of the ultrasound image. The patient’s record should also establish why ultrasound guidance was medically necessary (eg body habitus, difficult landmarks).
What if my attempt at lumbar puncture was unsuccessful? Do I still get reimbursed for the attempt?
Reimbursement patterns vary depending on the payer. Additionally, some groups may choose not to code failed procedures for various reasons. If a group decides to code and bill for a failed procedure, a modifier is typically applied.
For example, if the procedure is partially reduced or not completed at the discretion of the physician or qualified health care professional, it may be reported with modifier 52 (“Reduced Services”). If the procedure is interrupted due to extenuating circumstances or a threat to the patient's well-being, it may be reported with modifier 53 (“Discontinued Procedure”), according to CPT guidelines. In both cases, there should be clear documentation about what portions of the procedure were completed and why the procedure was discontinued.
It’s important to note that both modifiers 52 and 53 usually result in reduced payment from payers.
What if multiple qualified healthcare professionals were involved in performing a lumbar puncture (for example, a different physician performed the procedure after a failed attempt)?
If multiple qualified healthcare professionals who work in the same group and the same specialty are involved in lumbar puncture, the procedure is only billed once.
Is a lumbar puncture bundled in the critical care E/M code (99291/99292)?
No, lumbar puncture is separately billable. Do not include the time spent performing the lumbar puncture in the total critical care time.
Updated December 2025
Disclaimer
The American College of Emergency Physicians (ACEP) has developed the Reimbursement & Coding FAQs and Pearls for informational purposes only. It is recommended to consult related governing bodies for detailed and up-to-date information. The FAQs and Pearls have been developed by sources knowledgeable in their fields, reviewed by a committee, and are intended to describe current coding practice. However, ACEP cannot guarantee that the information contained in the FAQs and Pearls is in every respect accurate, complete, or up to date.
The FAQs and Pearls are provided "as is" without warranty of any kind, either express or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Payment policies can vary from payer to payer. ACEP, its committee members, authors, or editors assume no responsibility for, and expressly disclaim liability for, damages of any kind arising out of or relating to any use, non-use, interpretation of, or reliance on information contained or not contained in the FAQs and Pearls. In no event shall ACEP be liable for direct, indirect, special, incidental, or consequential damages arising from the use of such information or material. Specific coding or payment-related issues should be directed to the payer.
For information about this FAQ/Pearl, or to provide feedback, please contact ACEP's Reimbursement Team.
