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Discography is a diagnostic procedure utilized to evaluate the intervertebral discs in the cervical or thoracic regions of the spine. This procedure is particularly important for identifying whether abnormalities in the discs are contributing to a patient's back pain. During discography, the patient is typically positioned on their side to facilitate access to the targeted disc levels. The area where the injection will occur is meticulously cleansed with an antiseptic solution to minimize the risk of infection. Following this, a local anesthetic is administered to ensure the patient experiences minimal discomfort during the procedure. A large-bore needle is then carefully advanced through the skin and directed towards the disc under fluoroscopic guidance, which is a separate reportable service. Once the needle is properly positioned, a specialized discography needle is inserted through the initial needle and into the center of the disc. At this point, a contrast material is injected into the disc to enhance imaging clarity, and radiographs are obtained to visualize the disc's condition. It is important to note that if multiple discs are evaluated, the procedure can be repeated for each level, with specific codes assigned for cervical or thoracic discs, as indicated by CPT® Code 62291.
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The indications for performing a discography procedure include the following:
The procedure for discography involves several critical steps to ensure accurate diagnosis and patient safety:
After the discography procedure, patients may be monitored for any immediate adverse reactions to the contrast material or the anesthetic used. It is common for patients to experience some discomfort at the injection site, which typically resolves within a short period. Patients may be advised to rest and avoid strenuous activities for a brief period following the procedure. Additionally, the results of the discography, including any findings from the obtained radiographs, will be reviewed to determine the next steps in the patient's treatment plan. Follow-up appointments may be scheduled to discuss the results and any further diagnostic or therapeutic interventions that may be necessary.
| Short Descr | NJX PX DISCOGRAPHY CRV/THRC | Medium Descr | INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC | Long Descr | Injection procedure for discography, each level; cervical or thoracic | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 4 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2007-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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