Radiology Coding Alert

Question: Codes 62290 and 62291 specify "each level." May we report related codes 72285 and 72295 per level, as well, or once per session?

Illinois Subscriber

Answer: Per level reporting is appropriate for 72285 (Discography, cervical or thoracic, radiological supervision and interpretation) and 72295 (Discography, lumbar, radiological supervision and interpretation). So you may report the radiological supervision and interpretation (RS&I) codes once per level, just as you do injection codes 62290 (Injection procedure for discography, each level; lumbar) and 62291 (... cervical or thoracic).

Support: CPT® Assistant (March 2010) describes discography and offers a coding example for a three-level lumbar discography for payers who allow use of modifier 51 (Multiple procedures):

• 62290
• 62290-51 - 2
• 72295
• 72295-51 - 2.

Note: Different payers may have different preferences for how you report multiple procedures reported by the same code (such as multiple units rather than a modifier).

Procedure: Diagnostic discography involves two separate components, CPT® Assistant explains. One part involves inserting the needle in the disc and injecting contrast. The other part involves checking the dye pattern, interpreting the disc structure, and perhaps interpreting pain response. A single physician may perform (and report) both components, or in some cases one physician may perform (and report) the injection while another performs (and reports) the RS&I.

Tip: You should not report 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures ...) or any other fluoro code because the contrast injection and localization are part of the discography injection code, CPT® Assistant states.