June 23, 2016

Question:
What codes are used for a myelogram? Our schedulers have been told different things, the last being to just use 76000 and that it included the myelo and fluoro regardless of level.

Answer:
Actually, that is incorrect. The codes changed in 2015 so now it depends on which provider performs what service. But first, 76000 should never be reported with any of the myelogram injection codes.

Here are the guidelines:

• Use a combined injection / reading code (62302 – 62305) if the same provider performs both injection and radiological supervision and interpretation.

• The same provider should not report 62284 and the associated radiology code (e.g., 72240, 72255, 72265, or 72270). Rather, use the appropriate new combined service code (62302 – 62305).

• If different providers perform the injection and radiological supervision/interpretation, use 62284 for the provider performing the lumbar injection. The provider doing the radiological supervision will report 72240, 72255, 72265, or 72270. Basically, each provider reports his/her own service.

*This response is based on the best information available as of 06/23/16.