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Myelography is a specialized imaging technique utilized to obtain detailed visualizations of the spinal canal, spinal cord, and spinal nerve roots. This procedure employs real-time fluoroscopy in conjunction with X-ray imaging to create comprehensive images that assist in diagnosing various spinal conditions. Myelography is particularly valuable in identifying issues such as intervertebral disc herniation, spinal stenosis, tumors, infections, inflammation, and other lesions that may arise due to disease or trauma. During the procedure, the patient is typically positioned either lying on their abdomen or side to facilitate access to the lumbar region of the spine. A spinal needle is carefully advanced into the spinal canal under fluoroscopic guidance until cerebrospinal fluid (CSF) is observed to flow freely, indicating proper placement. Following this, a non-ionic contrast material is injected into the subarachnoid space to enhance the visibility of the spinal structures. The flow of the contrast dye is monitored through fluoroscopy, and X-rays are subsequently taken to document any abnormalities present. Upon completion of the myelography, the procedure table is returned to a horizontal position, allowing the patient to assume a comfortable posture. The specific CPT® code 62302 is designated for myelography performed via lumbar injection with a focus on the cervical region of the spine, while other codes are available for different spinal areas, including thoracic and lumbosacral regions.
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The myelography procedure is indicated for a variety of conditions affecting the spinal structures. These include:
The myelography procedure involves several critical steps to ensure accurate imaging of the spinal structures. The process begins with the patient being positioned either lying on their abdomen or side, which allows for optimal access to the lumbar region of the spine. Under the guidance of fluoroscopy, a spinal needle is carefully advanced into the spinal canal. The clinician observes for a free flow of cerebrospinal fluid (CSF), which indicates that the needle is correctly placed within the subarachnoid space. Once proper placement is confirmed, a non-ionic contrast material is injected through the needle into the subarachnoid space. This contrast dye enhances the visibility of the spinal structures during imaging. After the injection, the procedure table is slowly tilted up or down, allowing the contrast material to flow within the subarachnoid space, which is monitored in real-time using fluoroscopy. Following the flow of the dye, X-rays are obtained to document any abnormalities present in the spinal canal, spinal cord, or nerve roots. Upon completion of the imaging, the procedure table is returned to a horizontal position, and the patient is allowed to assume a comfortable position.
After the myelography procedure, patients are typically monitored for any immediate adverse reactions to the contrast material. It is common for patients to experience some discomfort or headache following the procedure, which may be managed with appropriate analgesics. Patients are usually advised to remain hydrated and may be instructed to rest for a period before resuming normal activities. Follow-up care may include additional imaging or consultations based on the findings from the myelography. It is essential for patients to report any unusual symptoms, such as severe headaches, neurological changes, or signs of infection, to their healthcare provider promptly.
| Short Descr | MYELOGRAPHY LUMBAR INJECTION | Medium Descr | MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL | Long Descr | Myelography via lumbar injection, including radiological supervision and interpretation; cervical | 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 | T-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | I1B - Standard imaging - musculoskeletal | MUE | 1 |
| 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 | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | 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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period |
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| 2015-01-01 | Added | Added |
| 1987-12-31 | Deleted | Code deleted. |
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