What’s new for myelography coding, Part 2

By Coding Strategies on February 20th, 2015

In Part 1 we discussed the changes to the CPT® codes for myelograms in 2015 but there are also some important bundling edit changes that we need to review. Adding to the complexity of appropriately reporting myelogram studies, CCI edits were revised in July of 2014 that bundle the CT of the spine and the x-ray myelogram code. The AMA addresses these CCI edits in the September 2014 issue of CPT Assistant. First, the AMA addresses reporting myelograms followed by spinal CTs for dates of service between 7/1/2014 and 12/31/2014. When a conventional x-ray myelogram is followed by a CT of the spine, the AMA states modifier 59 should be applied. The CCI edits bundled the myelograms codes into the CT Spine codes. For example, on August 15, 2014 a myelogram of the lumbar spine was performed, followed by a CT of the lumbar spine, with contrast. The appropriate code assignment is:

62284 Injection procedure for myelography and/or computed tomography, lumbar;

72265-59   Myelography, lumbosacral, radiological supervision and interpretation; and

72132 Computed tomography lumbar spine, with contrast material

This same procedure performed by a single physician on January 15, 2015 would be reported with the following codes:

62304 Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral

72132 Computed tomography lumbar spine, with contrast material

No modifier is needed in this scenario as there no CCI edits for this code pair were included in the January 2015 quarterly edit update.

As of January 1, 2015, if one physician performed the injection and a second physician read the myelogram and CT, the appropriate code assignment is:

Physician #1

62284 Injection procedure for myelography and/or computed tomography, lumbar;

Physician #2

72265- (59 or XU) Myelography, lumbosacral, radiological supervision and interpretation; and

72132 Computed tomography lumbar spine, with contrast material

With so many changes impacting coding and reimbursement for myelograms, now is the time to review your current coding practices and see how these changes will impact your practice.