Wiki Ct myelograms w/contrast or w/o?

[claudiak]

:Hello Radiology Experts.
I am hoping you can help me with a questions on ct myelograms. We normally bill cpt codes 62284 (for the intrathecal injection procedure spinal, other than C1-C2, and cpt 72240 for (myelography, cervical radilogical supervision and interpretation, and also cpt 72126 (Ct cervical spine with contrast material.

We have some payors that are denying cpt 72156 and stating we should be billing for cpt 72125 (ct cervical spine without contrast).

Does anyone out there have experience with these procedures and are the payors correct in stating that the ct cervical spine after the myelogram injection should be ct cervical spine without contrast?

Thanking you in advance for any and all help.

ClaudiaK
Networker

 

[jgf-CPC]

Yes, I also had the same question at one time and found that the CT after the myelogram should be billed without the contrast charge.

 

[AuntJoyce]

CT/Myelograms...

I coded Interventional and Diagnostic Radiology for a couple of years and the one thing that stands out in my mind is something the physician's drilled into me...if a patient has a CT/Myelogram and has contrast injected for the primary procedure - both studies automatically must be charged as " with contrast" by virtue of the fact that the contrast is still "flowing". Often, insurance carriers don't recognize the fact that if a patient has 5 scans performed and contrast is given for the first scan, all subsequent scans are read with contrast on board.

 

[jgf-CPC]

I guess I misunderstood the question. I thought it was whether to bill for the contrast or not again....my mistake

 

[Sephardic]

I have always billed them as with. There is a very good paragraph at the very beginning of the radiology section in the CPT book. (don't have the book with me right now) but it bascially describes the definition of contrast and how to code them. It says that you can bill them as with contrast if the injection is done intravascular, intrathecaly, or intraarticular.