2025 CPT code 72295
(Active) Effective Date: N/A Revision Date: N/A Radiology - Radiologic Examination Musculoskeletal System Feed
Radiological supervision and interpretation of lumbar discography.
Modifiers 26 (professional component) and 52 (reduced services) may be applied as per the payer's guidelines and clinical circumstances.
Medical necessity for a lumbar discography is established when other less invasive diagnostic methods have failed to provide a conclusive diagnosis or when the clinical presentation strongly suggests a specific disc pathology requiring targeted evaluation. Specific criteria may vary by payer.
The clinical responsibility for this code lies with the radiologist who supervises the injection procedure and interprets the resulting discogram images. This includes reviewing the images, identifying any abnormalities, and generating a report for the referring physician.The radiologist does not perform the injection itself.
In simple words: This code covers the doctor's work in overseeing and interpreting x-ray images of the lower back's discs. A special dye is injected into the disc, and x-rays are taken to check for problems like tears or bulges. The doctor doesn't do the injection; they only watch it and examine the pictures afterward.
This CPT code, 72295, encompasses the radiological supervision and interpretation of a lumbar discography.The procedure involves injecting contrast material into the intervertebral disc space of the lumbar spine under fluoroscopic guidance.A series of x-ray images are then acquired to visualize the disc and assess for injury or protrusion. The physician's role is limited to the supervision of the injection procedure and the subsequent interpretation of the resulting images.Fluoroscopic guidance for the injection itself is not included in this code and should be reported separately if performed by a different provider.
Example 1: A patient presents with chronic low back pain. The physician orders a lumbar discography to evaluate for disc herniation.The radiologist supervises the procedure and interprets the post-injection x-rays. The radiologist documents the findings and creates a report., A patient with a history of spinal stenosis undergoes a lumbar discography to identify the source of their pain. The interventional radiologist performs the injections, and a separate radiologist provides supervision and interpretation.Both providers utilize appropriate modifiers to bill their services., A patient experiencing radiculopathy undergoes a discography, with a radiologist providing supervision and interpretation of the x-ray images. The radiologist's report highlights the presence of any abnormalities within the intervertebral discs, helping to pinpoint the cause of the patient's nerve-related pain.
* Patient demographics and relevant medical history.* Indication for the procedure.* Detailed description of the procedure performed, including the type and amount of contrast material used.* Number and type of images obtained.* Radiologist's interpretation and diagnosis.* Physician's signature and date.
** Always refer to the most up-to-date CPT codebook and payer guidelines for accurate coding and billing practices.This information is for guidance only and should not be considered exhaustive.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- RVU: This information requires access to current Relative Value Unit (RVU) data specific to the payer and geographic location. RVUs are subject to frequent updates.
- Global Days: This code does not involve a global surgical period.
- 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.
- Fee Schedule: Historical fee schedule data is not provided here.Consult your payer's fee schedule for historical data.
- Specialties:Radiology, Interventional Radiology, Pain Management
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center