Summary & Overview
CPT 62304: Lumbar Myelography with Contrast Injection and Interpretation
CPT code 62304 represents a lumbar myelography procedure in which contrast is injected into the lumbar intrathecal space and radiological supervision and interpretation are provided. Nationally, this code captures an important diagnostic imaging service for evaluating spinal canal and nerve root pathology when MRI is inconclusive or contraindicated. Utilization of intrathecal myelography has implications for imaging capacity, procedural staffing, and radiology billing nationally.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service settings, common billing considerations, and benchmarking context against major commercial payers and Medicare reimbursement patterns. The publication also outlines procedural components captured by the code, common sites of service, and the types of clinical questions the study aims to address.
This summary is intended to orient payers, clinical leaders, and revenue cycle teams to the clinical scope and billing classification of CPT code 62304. Data not available in the input is noted where applicable; the content focuses on national relevance rather than state-specific policy.
Billing Code Overview
CPT code 62304 describes the administration of an injection of contrast into the lumbar spine with performance of myelography at the lumbosacral region, including radiological supervision and interpretation. This procedure involves intrathecal contrast injection and fluoroscopic imaging to evaluate the spinal canal and nerve root impingement in the lumbar and sacral segments.
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Service type: Image-guided diagnostic spinal myelography with contrast injection
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Typical site of service: Hospital outpatient radiology suite or ambulatory surgery center, where fluoroscopic and radiologic interpretation resources are available
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Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with progressive lumbar radiculopathy and symptoms suggesting compression of the cauda equina is referred for diagnostic myelography. The patient reports worsening lower extremity pain, numbness, and intermittent neurogenic claudication despite conservative management. After informed consent and pre-procedure screening for contrast allergy and renal dysfunction, the patient is positioned in the radiology suite. Under sterile technique, the provider performs a lumbar puncture at the appropriate level, injects iodinated contrast into the subarachnoid space, and obtains fluoroscopic myelographic images of the lumbosacral spine. Radiological supervision and interpretation are provided by the performing physician. The images guide subsequent clinical decisions, which may include MRI correlation or surgical consultation for decompression if significant stenosis or disc herniation is identified. Typical site of service is an outpatient radiology department or hospital-based imaging center with fluoroscopy capability and resuscitation resources.
Coding Specifications
- Below are the most clinically relevant modifiers for
62304with typical use cases.
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances or modifiers apply for the service. |