Coding Skills for Lumbar Myelogram CPT code

Coding Skils for Lumbar Myelogram CPT code
English: Diagrammatic transverse section of the medulla spinalis and its membranes. (Photo credit: Wikipedia)
In Medical coding, there are many diagnostic exams for spinal region. Spinal procedures are a part on non-vascular radiology procedure. The exams are to find any abnormality in spinal subarachnoid space and its content. Myelogram is one procedure, which is to find any diagnosis related to spinal region. Myelogram procedure focuses on lumbar and cervical region. We are going to study the Lumbar Myelogram procedure CPT codes used in medical coding.

Procedure of Lumbar Myelogram

The procedure takes place in sterile condition. The contrast medium injected in the thecal sac under fluoroscopic visualization. The contrast medium helps in to find the diagnostic finding in spinal subarachnoid space. The contrast medium injected in the lumbar area. Images taken under fluoroscopic guidance help in finding the diagnosis. The CPT procedure code for lumbar Myelogram coded in such cases.

CPT code used for Lumbar Myelogram

Coding Skils for Lumbar Myelogram CPT code
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The CPT code depends on the spinal area examined. We have two codes for lumbar and cervical Myelogram. Lumbar Myelogram Cpt Code is most commonly used. The CPT code for Myelogram decided on the Injection area. If the contrast injected in Lumbar area to study Lumbar spine we have to code Lumbar Myelogram. However, when the contrast injected in Lumbar area and study done on cervical spine then also we have to code Lumbar Myelogram. The only difference will be the Supervision and Interpretation CPT code. Let understand with following scenarios

When a patient is having lumbar diagnosis, Lumbar Myelogram performed and Diagnostic finding documented. The contrast medium injected in Lumbar region. Here we code the Lumbar Myelogram CPT code followed by the Lumbar diagnostic S&I code.

62304 Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral

A patient with cervical diagnosis and contrast medium injected in lumbar region. However, after injection of contrast medium the patient made upside down to allow contrast to flow form lumbar to cervical. Therefore, here also, we have to code Lumbar Myelogram code followed by the Cervical S&I code.   

62302 Myelography via lumbar injection, including radiological supervision and interpretation;cervical
When a patient is having thoracic diagnosis and the contrast medium injected via lumbar region to examine the thoracic spine region. Also if Supervision and interpretation is provided, we have to use combine CPT code.

62303 Myelography via lumbar injection, including radiological supervision and interpretation; thoracic
We have new CPT code for myelography when performed in two or more spinal region included the supervision and interpretation. 

62305 Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)

Point to remember for CPT Code Lumbar Myelogram

The most important point to check for injection point in spinal region, since the cervical region is examined from the injection the lumbar region. Since, we have separate code for Injection of Contrast in Cervical (C1-C2) and Lumbar region we have to be very careful while coding. Secondly, while coding the S&I code we have to check properly for lumbar and cervical spine finding. We have separate S&I code for both Cervical and Lumbar region. Do not code an S&I code for cervical finding when the report document the lumbar finding.

Avoid coding below CPT codes with the above listed new CPT code of myelography bundled with supervision and interpretation.


62284 Injection procedure for myelography and/or computed tomography, lumbar (other than C1-C2 and posterior fossa)
72240 Myelography, cervical, radiological supervision and interpretation
72255 Myelography, thoracic, radiological supervision and interpretation
72265 Myelography, lumbosacral, radiological supervision and interpretation

Hope, you can code Myelogram Procedure CPT Code nicely after reading this article, do share if you liked it.

References:
http://www.acr.org/Advocacy/Economics-Health-Policy/Billing-Coding/Coding-Source-List/2006/Mar-Apr-2006/Coding-of-Diagnostic-and-Therapeutic-Spinal-Procedures

https://www.aapc.com/blog/30935-get-a-clear-picture-of-myelography-reporting/

http://www.codingstrategies.com/blog/what%E2%80%99s-new-myelography-coding-part-2

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