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Wiki Conventional vs non-myelogram

rblanton

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What is the diffeerence and how would I code a lumbar myelogram?
 
CT Myelography
A CT myelogram is a CT scan performed after intrathecal (spinal) contrast injection. A CT myelogram is coded as a CT scan with contrast (for example, CPT® code 72132 for CT myelogram of the lumbar spine). In addition, the contrast injection should be coded (for example, 62284 for spinal injection other than C1-2 or posterior fossa). If fluoroscopy is used to guide the injection, code 76005 can also be reported. However, if a conventional myelogram is performed (for example, 72265 for lumbosacral myelogram) in addition to CT myelogram, fluoroscopy cannot be reported as it is considered a component of the conventional arthrogram.
Example:
Under fluoroscopic guidance, contrast is injected into the lumbar spine, following which CT lumbosacral myelogram is performed. Report codes 62284, 76005, and 72132.

62284-physician injects dye into the epidural or intrathecal space for myelography and/or computed tomography. The patient is placed in a spinal tap position. The site is placed to the proper level and the dye is administered. The needle is removed and wound dressed.

72265-Radiographic study using fluro is performed on the spinal cord and nerve root branches when a lesion is suspected. A nonionic water-soluble radiopaque contrast media is used to enhance visibility and is instilled in the patient through a lumbar or cervical area puncture into the subarachnoid space. The radiologist takes a series of pictures by sending and xray beam thru the body using fluro to enhance structure on a television camera. The pt is angled from an erect position through a recumbent position with the body tilted so as to maintain feet higher than the head to help the flow of contrast into the study area.
 
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