Results 1 to 8 of 8

Discogram followed by CT

  1. #1
    Question Discogram followed by CT
    Exam Training Packages
    I was wondering if anyone can advise if it is appropriate to charge a CT w/Contrast following a Discogram? Thanks for any info!

    CSwift CPC

  2. #2
    Default
    Since they will be looking at the CT with the contrast injected by the discogram you would charge a CT with contrast but not for the contrast itself since it was injected during the discogram. Hope that makes sense and helps!

  3. #3
    Default
    Thank you for taking the time to respond to me! So, since the contrast is injected into the disc and not intravascularly, intra-articularly, or intrathecally, per the CPT book, then it is ok to charge for a CT w/Contrast?

  4. #4
    Default
    Yes, since the contrast is still there while the CT is being done then it would be read as with contrast. As long as you do not charge for it.

  5. #5
    Default
    Great! Thank you so much!

  6. #6
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by jgf-CPC View Post
    Since they will be looking at the CT with the contrast injected by the discogram you would charge a CT with contrast but not for the contrast itself since it was injected during the discogram. Hope that makes sense and helps!
    This is incorrect. The guidelines in CPT for contrast usage (beginning of Radiology section) are quite clear that to be considered a "with contrast" CT or MRI, the contrast must be injected IV, intrathecally or intra-articularly. Contrast for a diskogram does not meet any of those - it is injected intradiscally. Therefore the CT is "without contrast".

  7. #7
    Default
    I hope this clarifies my explanation of the contrast being there during the CT:

    Needles are inserted through the back into the disc near the suspect area, guided by fluoroscope imaging. Fluid is then injected to pressurise the disc, any pain responses are recorded.

    This is repeated in random order for the various discs, without the patient knowing which disc is pressurised. This can be used to detect patients who may be exaggerating their symptoms, or to assess their pain response and hence their suitability for recovery from possible surgery (often a Discectomy).

    A contrast agent is introduced, and after the procedure a CT scan identifies leakage from the discs to identify any spinal disc herniation.

  8. #8
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by jgf-CPC View Post
    I hope this clarifies my explanation of the contrast being there during the CT:

    Needles are inserted through the back into the disc near the suspect area, guided by fluoroscope imaging. Fluid is then injected to pressurise the disc, any pain responses are recorded.

    This is repeated in random order for the various discs, without the patient knowing which disc is pressurised. This can be used to detect patients who may be exaggerating their symptoms, or to assess their pain response and hence their suitability for recovery from possible surgery (often a Discectomy).

    A contrast agent is introduced, and after the procedure a CT scan identifies leakage from the discs to identify any spinal disc herniation.
    Yes, but look at your description- the contrast is injected into the disc. It is not injected intrathecally nor is it IV. . Just the fact that there is contrast does not mean that a "with contrast" CT should be coded. You do not code "with contrast" for an exam where only oral contrast is given, even though there is contrast seen in the images. Nor would you code a "with contrast" exam for a CT of the urinary tract when the contrast is injected through a bladder catheter. Contrast is seen on the CT but it is still a "without contrast" exam.

Similar Threads

  1. Discogram 72295 each level
    By RACOBB in forum Interventional Radiology
    Replies: 1
    Last Post: 05-02-2011, 03:20 PM
  2. Marcaine discogram
    By Sephardic in forum Interventional Radiology
    Replies: 0
    Last Post: 11-10-2009, 02:53 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.