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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 flowing freely, indicating proper placement. Subsequently, a non-ionic contrast material is injected into the subarachnoid space through the needle, allowing for enhanced visualization of the spinal structures. The procedure involves tilting the procedure table to enable the contrast dye to flow throughout the subarachnoid space, with fluoroscopy monitoring the flow and X-rays being taken to document any abnormalities. Upon completion of the myelography, the table is returned to a horizontal position, and the patient is permitted to assume a comfortable posture. It is important to note that different CPT® codes are designated for myelography based on the specific spinal region being examined: code 62302 for the cervical region, code 62303 for the thoracic region, code 62304 for the lumbosacral area, and code 62305 when two or more spinal areas are evaluated.
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Myelography via lumbar injection is indicated for a variety of conditions affecting the spinal structures. The following are the explicitly provided indications for this procedure:
The myelography procedure involves several critical steps to ensure accurate imaging of the spinal canal. The following procedural steps are outlined:
Post-procedure care for myelography includes monitoring the patient for any immediate adverse reactions to the contrast material. Patients are typically advised to rest and may be instructed to drink plenty of fluids to help flush the contrast dye from their system. It is also important to observe for any signs of complications, such as headache, back pain, or neurological symptoms. Follow-up imaging or evaluations may be scheduled based on the findings from the myelography.
| Short Descr | MYELOGRAPHY LUMBAR INJECTION | Medium Descr | MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC | Long Descr | Myelography via lumbar injection, including radiological supervision and interpretation; 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 | 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 |
| 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | 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 | 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 |
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| 2015-01-01 | Added | Added |
| 1987-12-31 | Deleted | Code deleted. |
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