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Myelography is a specialized diagnostic imaging procedure that involves the use of contrast material to visualize the spinal cord and its surrounding structures. This procedure is performed by injecting a contrast agent into the subarachnoid space, which is the area surrounding the spinal cord. The injection is typically done using a needle that is carefully placed into the spinal canal. Once the contrast material is introduced, real-time fluoroscopic X-ray imaging is utilized to monitor the flow of the contrast agent through the spinal canal, allowing for a dynamic assessment of the spinal anatomy. The radiologist can observe the spinal cord, nerve roots, meninges, and blood vessels as the contrast material enhances these structures, making them more visible on the imaging studies. In addition to real-time imaging, permanent X-ray images may also be captured during the procedure for further analysis. Myelography is particularly useful in diagnosing various spinal conditions, including intervertebral disc herniation, meningeal inflammation, spinal stenosis, tumors, and other lesions that may arise from infections or previous injuries. The CPT® code 72270 specifically refers to myelography performed on two or more regions of the spine, such as combinations of lumbar, thoracic, and cervical areas, providing a comprehensive evaluation of the spinal anatomy across multiple segments.
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Myelography is indicated for a variety of conditions affecting the spinal cord and its surrounding structures. The following are the explicitly provided indications for performing this procedure:
The myelography procedure involves several critical steps to ensure accurate imaging and patient safety. The following outlines the procedural steps as described:
After the myelography procedure, patients are typically monitored for a short period to ensure there are no immediate complications, such as headaches or allergic reactions to the contrast material. It is common for patients to experience some discomfort or mild headache following the procedure, which can usually be managed with over-the-counter pain relief. Patients are often advised to stay hydrated and may be instructed to rest for a period of time. Follow-up care may include additional imaging or consultations based on the findings from the myelography. It is important for patients to report any unusual symptoms, such as severe headaches, neurological changes, or signs of infection, to their healthcare provider promptly.
| Short Descr | MYELOGPHY 2/> SPINE REGIONS | Medium Descr | MYELOGRAPY 2/MORE REGIONS RS&I | Long Descr | Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | 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 |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Changed | Code description changed |
| 2004-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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