Wiki myelography - 62304 & 72132 - help needed

[M1CcKb81]

Patient had CPT 62304 (XR myelography lumbar) L4-5 level with spinal needle and injection of contrast under fluoroscopic guidance. Images were obtained. Then the patient was transferred to the CT suite for that portion of the exam. At this point 72132 CT spine Lumbar with contrast was completed.

Could someone provide information on whether these two codes are inclusive to each other and thus only 62304 should be billed. Or should both codes be billed with a -59 modifier on one. I checked NCCI and did not see anything listed regarding billing these together or not. Have read other information on the forum, but still struggling with this one.

Some information leads me to believe they should both be billed, and other information makes me think only 62304 should be billed. Thank you in advance for any information/guidance regarding this.

 

[iowagirl77]

Per NCCI: Computed tomography (CT) of the spine with intrathecal contrast shall not be reported with myelography (e.g., CPT codes 72240-72270) unless both studies are medically reasonable and necessary. Radiography after injection of intrathecal contrast to perform a CT of the spine in order to confirm the location of the contrast is not separately reportable as myelography.

So it sounds like as long as you are doing the myelography first, rather than secondarily to the CT to confirm the contrast location, they are both billable.

 

[M1CcKb81]

Thank you so much. Your information is very helpful.