Radiology Coding Alert

Question: Our radiologist performed diskography on three levels of the lumbar spine. Depo Medrol was injected at one level. Can this injection be billed in addition to the diskogram? Billing is all done globally on the HCFA 1500. This is an outpatient center with no hospital affiliation.

Andi Litschko
Cleveland, Ohio

Answer: The diskography service should be coded 62290* (injection procedure for diskography, each level; lumbar) three times (once for each level) and 72295 (diskography, lumbar, radiological supervision and interpretation) three times (once for each level). These codes include a puncture and, therefore, you would not assign an additional code for the Depo Medrol injection, unless separate punctures are used for the diskogram and the Depo Medrol.

You can attempt to report the cost of the steroid through the use of a supply code, but many payers will not reimburse for this expense. There are three codes used to report Depo Medrol, depending on the strength of the medication: J1020 is for Depo Medrol, 20 mg; J1030 is for 40 mg; and J1040 is for 80 mg. The HCPCS supply codes are billed only when the cost of purchasing the drug is paid by the billing entity. Hospital-based radiologists generally do not bill for the drug cost.