IR( interventional radiology)-9

                                                 Myelogram:

A myelogram uses X-rays and a special dye called contrast material to take pictures of the bones and the fluid-filled space (subarachnoid space) between the bones in your spine (spinal canal). A myelogram may be done to find a tumor, an infection, problems with the spine such as a herniated disc, or narrowing of the spinal canal caused by arthritis.
IR( interventional radiology)-9 Myelogram
Myelogram

The spinal canal holds the spinal cord, spinal nerve roots, and the subarachnoid space.

During the test, a dye is put into the subarachnoid space with a thin needle. The dye moves through space so the nerve roots and spinal cord can be seen more clearly. Pictures may be taken before and after the dye is used. To get more information from the test, a CT scan is often done after the X-rays, while the dye is still in your body.

Coding Tip:
Injection (Procedure code) should be coded only once, even for multiple myelograms.
No need to code lumbar puncture separately, it is bundled in the Myelogram procedure.

CPT CODE:-
62302 Myelography via lumbar injection, including radiological
supervision and interpretation; cervical
62303 thoracic
62304 lumbosacral
62305 2 or more regions (eg, lumbar/thoracic, cervical/
thoracic, lumbar/cervical, lumbar/thoracic/cervical)

Note:-
For myelography injection and imaging performed
by different physicians or other qualified health care
professionals, see 62284 or 72240, 72255, 72265, 72270

Don't:-
Do not report 62303 in conjunction with 62284, 62302,
62304, 62305, 72240, 72255, 72265, 72270
Do not report 62304 in conjunction with 62284, 62302,
62303, 62305, 72240, 72255, 72265, 72270
Do not report 62305 in conjunction with 62284, 62302,
62303, 62304, 72240, 72255, 72265, 72270

Injection:-
61055- (C1-C2)with an injection of medication or other substance for
diagnosis or treatment
62284- Injection procedure for myelography and/or computed
tomography, lumbar

1. Sample Report:
CERV MYELOGRAM
HISTORY: Neck pain
The patient was informed of the procedure including potential
complications up to and including death. To the best of my knowledge
she understood and consented. Her back was prepped with Betadine and
alcohol. The soft tissues at L three L4 were infiltrated with
lidocaine and I used a 25-gauge Whitaker needle to make midline
lumbar puncture. Clear colorless CSF was obtained and 10 mL of 300
mg/mL Isovue M was introduced into the subarachnoid space.
Multiple films reveal solid interbody fusions C4 through C6 with
anterior plate and screws. Spondylosis exists at C3-C4 with
posterior displacement of the sac and thinning of the left C4 nerve
root. Additional spondylosis is present at C6-C7 and neither C7 root
is well filled.
Conclusions: Solid fusion C4 through C6. Spondylosis above and
below the fusion site.

2.Sample report:
CERV/THOR/LUM MYELO 2+ REGIONS
HISTORY: Back pain neck pain.
Myelography was explained to the patient along with potential
complications up to and including death. To the best of my knowledge,
she understood consented. Her back was prepped with Betadine and
alcohol. The soft tissues were infiltrated with lidocaine IUs of 22
gauge Whitaker needle makes lumbar puncture at L2-L3. Clear colorless
CSF was obtained and 10 mL of 300 mg/mL Isovue M was introduced into
the spinal canal.
Lumbar myelography: Multiple films reveal an interbody fusion with
a bone through the cage at L4-L5. Pedicular screws and posterior
process fusion bone are present. There is a mild disc bulge across
midline at L5-S1 and the interspace is mildly narrowed. On the erect
film, both S1 roots show evidence. The upper lumbar region is not normal.
Cervical myelography: Solid interbody fusion C6-C7 with anterior
plate and screws. There is mild spondylosis C4 through C6 and at C
71. The root sheaths bilaterally at C4-C5 are partially amputated.
IMPRESSION:
Lumbar myelography: Lateral recess encroachments L5-S1 worse on the
left.
Cervical myelography: Mild spondylosis with bilateral root sheath
encroachments at C4-C5.

HISTORY:
Back pain
The patient was appraised of the exam including potential complications
up to and including death. To the best of my knowledge, she understood
consented. Her back was prepped with Betadine and alcohol. The soft
tissues L2-L3 were infiltrated with lidocaine 9 IU of 25-gauge
Whitaker needle for lumbar puncture. Clear colorless CSF was
obtained and 15 mL of 200 mg/mL Isovue M was introduced into
subarachnoid space
Lumbar myelography: Solid transverse process fusion L4 through S1.
The L4-L5 interspace is narrowed and dense. Fusion cage lies at
L5-S1 with probable bone. The thecal sac is not deflected. There is
minimal postsurgical irregularity.
Mild disc bulge at L3-L4, immediately above the fusion.
A spinal stimulator device overlies the right side of the spine.
Thoracic myelography: A free flow of contrast occurred in the
thoracic region. Spinal stimulator leads lies dorsally in the canal
at T7-8.
Conclusion: Thoracic myelography is grossly normal.
Lumbar myelography: Solid interbody and transverse process fusion L4
through S1. Thoracic myelography is grossly normal.
Lumbar myelography: Solid interbody and transverse process fusion L4
through S1.


Recomended Books:-


   

Post a Comment

0 Comments