2025 CPT code 72270
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging Procedures - Diagnostic Radiology Radiology Feed
Myelography of two or more spinal regions; radiological supervision and interpretation.
Modifiers -26 (professional component) and -52 (reduced services) may apply based on the involvement of multiple providers.Other modifiers may apply depending on the specific circumstances of the procedure.
Medical necessity for a myelogram is established when other less invasive imaging modalities (e.g., MRI, CT) have failed to provide sufficient information for diagnosis or when specific clinical indications warrant this procedure (e.g., suspected spinal cord compression, nerve root impingement, or other spinal abnormalities). The ordering physician must clearly document the clinical rationale and justification for the myelogram.
The physician's responsibilities include pre-procedure patient assessment and preparation, overseeing the injection of contrast material (if performed by the physician), fluoroscopic guidance (if performed by the physician), acquiring the appropriate imaging views, and the detailed interpretation of all resulting images to generate a comprehensive diagnostic report.This could involve adjusting patient positioning to obtain optimal image quality.
In simple words: This code covers the doctor's work in overseeing and interpreting x-rays of the spine after a special dye is injected to better visualize the spinal cord and surrounding nerves. The x-rays are taken to check for any problems in two or more areas of the spine.
This CPT code encompasses the radiological supervision and interpretation of a myelogram involving two or more regions of the spinal canal (e.g., lumbar/thoracic, cervical/thoracic, lumbar/cervical, or lumbar/thoracic/cervical).The procedure involves injecting contrast material into the subarachnoid space under fluoroscopic guidance, visualizing multiple spinal canal regions, and obtaining a series of x-ray images to identify spinal canal injuries or abnormalities.The physician's responsibility includes image acquisition oversight, contrast injection supervision (if performed by the physician), and the comprehensive interpretation of the resulting radiographic images.
Example 1: A 60-year-old patient presents with lower back pain and neurological symptoms. A myelogram of the lumbar and thoracic spine is performed, revealing a herniated disc at L4-L5. The physician supervises the contrast injection and interprets the images., A 45-year-old patient with suspected spinal stenosis undergoes a myelogram of the cervical and thoracic spine.The physician supervises the procedure performed by a technologist and carefully analyzes the images to assess the extent of the spinal canal narrowing., A 72-year-old patient with unexplained neurological deficits undergoes a comprehensive myelogram of the cervical, thoracic, and lumbar spine. The physician oversees the entire process and renders a detailed report of the findings, which includes identifying specific areas of cord compression or other abnormalities.
* Complete patient history and physical examination notes.* Detailed description of the indication for the myelogram.* Documentation of the contrast medium used.* Specific regions of the spine imaged.* Number of images acquired.* Detailed radiological report including interpretation and diagnostic findings.* Any complications encountered.
** This code specifically addresses the professional component (interpretation and supervision).If the physician also performs the injection, separate codes for the injection and imaging must be reported. The number of regions involved directly impacts the level of effort and complexity involved, and therefore the medical necessity.
- Revenue Code: I4B (Imaging/Procedure - Other)
- Payment Status: Active
- Modifier TC rule: Modifier -TC (technical component) does not apply to this code as it represents the professional component of the service.
- Specialties:Radiology, Neurosurgery, Orthopedics
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center