Wiki 3D Myelogram CPT

[shruthi]

Radiology report is for Lumbar spine MRI without contrast. Also the report describes about - MR myelogram images were obtained with 3D image reformations.
Body of report descirbes about detailed MRI L spine and also about 3D Lumbar myelogram images.
Confirm if we need to code 3 codes - MRI L spine (72148), MR myelogram (72265) and 3D reconstruction (76376) or is 3D included in myelogram?

Thanks.

 

[polycoder]

Myelograms are usually fluoro as the guidance. Spot fluoro films are saved. I have never seen 3D done from fluoro. Was the 3D done with MRI perhaps? Also make sure that if just sagittal and coronal were done, this is not 3D.
If everything checks out, then yes 76376.

 

[donnajrichmond]

Radiology report is for Lumbar spine MRI without contrast. Also the report describes about - MR myelogram images were obtained with 3D image reformations.
Body of report descirbes about detailed MRI L spine and also about 3D Lumbar myelogram images.
Confirm if we need to code 3 codes - MRI L spine (72148), MR myelogram (72265) and 3D reconstruction (76376) or is 3D included in myelogram?

Thanks.

this is an MR myelogram - which is and MRI of the spine, coded with the appropriate MRI code. 72148 would be correct if contrast was not used, but I've never seen one without contrast I would double check about contrast. Code separately for 3D (76376 or more likely 73677) if 3D reconstructions are done under concurrent supervision (physician involvement in the reconstruction). There are MR sequences that acquire 3D images, so you must have documentation of post-processing.
Do not also code 72265 unless a separate, diagnostic radiographic myelogam is performed (and if it was, then there would have to be contrast, so 72149 would be the appropriate MRI code.