AMA CPT® Assistant - 2014 Issue 9 (September)
Radiology: Myelography and Injection Procedure (September 2014)
September 2014 pages 3-4 Radiology: Myelography and Injection Procedure This article provides recent coding updates related to the imaging of the spine with intrathecal contrast media. These changes reflect updates pertaining to myelography procedures reported with codes 72240, 72255, 72265, 72270, and the associated injection procedure, code 62284. Bundling of Lumbar Injection and Myelography Radiologic Supervision and Interpretation In CPT®2015 code set, the codes for intrathecal contrast administration via lumbar injection and X-ray myelographic radiologic supervision and interpretation (RS&I) will be bundled into a single new code, when both procedures are performed by the same physician or...
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Article Overview
This article explains recent coding updates for spine imaging procedures involving intrathecal contrast media, with emphasis on myelography, related injection procedures, and how upcoming CPT changes affect reporting. It is aimed at coders, billing staff, and radiology practices that need to understand when procedures are reported together or separately and how National Correct Coding Initiative guidance affects claims. The article also discusses broader imaging scenarios involving X-ray myelography and CT of the spine with contrast, along with timing and procedure-relationship considerations.
Why This Topic Matters
Radiology coding for myelography and contrast-based spine imaging can change based on procedure sequencing, provider roles, and CPT year updates. Understanding the article helps reduce claim errors and supports correct reporting under current and upcoming guidance.
Article Sections
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September 2014 pages 3-4
Introductory publication context and the general scope of the radiology coding update.
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Bundling of Lumbar Injection and Myelography Radiologic Supervision and Interpretation
Discussion of changes affecting how related myelography services are reported in the upcoming CPT code set and how provider participation affects reporting structure.
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Modifier 59
Overview of National Correct Coding Initiative guidance addressing when this modifier is associated with certain spine imaging services after a specified date.
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Features Unique to Myelography
General characteristics of myelography and how it differs from limited image documentation, including the imaging purpose and common procedural variations.
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Figure 1. Imaging Scenarios Following Intrathecal Injection
Illustrated scenario summary showing broad imaging pathways that may follow intrathecal injection and the general relationship between myelography and CT imaging.
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Coding Tip
Practical coding discussion covering procedure identification, sequence-related reporting considerations, and the relationship between injection services and subsequent imaging.
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Figure 2. Lumbar Injection, Myelographic Interpretation, CT Spine With Contrast After 7/1/2014 Until 2015: 1 or 2 Physicians
Visual example caption related to timing and reporting scenarios for lumbar injection and subsequent CT imaging during the transition period.
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Figure 3. Lumbar Injection, CT Spine With Contrast After 7/1/2014 Until 2015: 1 or 2 Physicians
Visual example caption showing a scenario in which CT follows injection during the same general reporting period.
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Figure 4. Lumbar Injection, Myelographic Interpretation, CT Spine With Contrast 2015: 1 Physician
Illustrated scenario for the 2015 code set where a single physician’s role is shown in relation to related spine imaging services.
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Figure 5. Lumbar Injection, Myelographic Interpretation, CT Spine With Contrast 2015: 2 Physicians
Illustrated scenario for the 2015 code set where two physicians are involved in related imaging services and interpretation.
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Coding Tip
Additional reporting guidance addressing CT imaging after intrathecal injection and how the presence or absence of X-ray myelography affects billing structure.
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Figure 6. Lumbar Injection, CT Spine With Contrast After 2015.
Visual example caption for a later reporting scenario involving lumbar injection and CT imaging without X-ray myelography.
What You Will Learn
- How the article frames coding updates for myelography-related spine imaging
- What general kinds of changes are discussed for the CPT 2015 code set
- How the article addresses modifier use in relation to spine CT imaging
- How provider roles and procedure sequencing are treated at a high level
- What broad imaging scenarios are illustrated after intrathecal injection
Who Should Read This
- Radiology coders
- Medical billing staff
- Compliance professionals
- Radiology practice administrators
- Physician coders
Codes Discussed
Modifiers Discussed
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