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Myelography, specifically posterior fossa myelography, is a specialized diagnostic imaging procedure primarily utilized to assess the cerebellopontine angles, particularly when there is a suspicion of an acoustic neuroma. This procedure involves the use of contrast material, which is injected into the subarachnoid space surrounding the spinal cord and nerve roots. The injection is performed through a lumbar puncture, allowing for the visualization of the central nervous system structures. The imaging is conducted using real-time fluoroscopic x-ray technology, which provides dynamic visualization of the contrast flow. During the procedure, the patient is positioned on their side, with their legs secured to a footboard to maintain stability. The table is then tilted, and the patient's head is flexed and extended to facilitate the movement of the contrast material into the upper cervical canal. As the contrast flows through the foramen magnum, it accumulates in the dependent cerebellopontine cistern and the internal auditory canal, enabling detailed imaging of these critical areas. Once the contrast has adequately filled the target regions, the table is returned to a horizontal position, and the patient's head is carefully adjusted to align the petrous ridge parallel to the top of the imaging film, allowing for the acquisition of high-quality images necessary for accurate diagnosis and evaluation.
© Copyright 2025 Coding Ahead. All rights reserved.
The primary indications for performing posterior fossa myelography include the following:
The procedure for posterior fossa myelography involves several key steps that ensure accurate imaging of the targeted areas.
After the completion of posterior fossa myelography, patients may be monitored for any immediate adverse reactions to the contrast material. It is essential to ensure that the patient is stable and does not exhibit any signs of complications. Patients are typically advised to remain hydrated and may be instructed to rest for a period following the procedure. Any specific post-procedure care instructions, including monitoring for headaches or other symptoms, should be provided to ensure a smooth recovery process. Follow-up imaging or assessments may be scheduled based on the findings from the myelography.
| Short Descr | CONTRAST X-RAY OF BRAIN | Medium Descr | MYELOGRAPY POST FOSSA RS&I | Long Descr | Myelography, posterior fossa, radiological supervision and interpretation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 0 - 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) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 1 | CCS Clinical Classification | 181 - Myelogram |
| RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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