Summary & Overview
CPT 62305: Lumbar Myelography with Contrast, Multiple Regions
CPT code 62305 denotes lumbar myelography with intrathecal contrast injection and radiological supervision and interpretation for two or more spinal cord regions. This procedure is an advanced diagnostic imaging service used to evaluate spinal canal pathology, nerve root impingement, and other structural abnormalities when MRI is contraindicated or additional anatomical detail is required. Nationally, myelography remains a specialized but important tool within neuroradiology and spine care pathways.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and reimbursement benchmarks, common billing and coding considerations, and clinical context for appropriate use. Readers will find an overview of typical service settings and procedure components, comparisons of payer coverage patterns and prior authorization trends where available, and notes on documentation and reporting elements relevant to radiological supervision and interpretation.
The content focuses on the clinical and billing definition of the service, typical sites of service, and what stakeholders should expect in payer engagement and claims processing. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 62305 describes administration of an injection of contrast into the lumbar region of the spine with myelography of two or more spinal cord regions, including radiological supervision and interpretation. This service involves intrathecal contrast injection and fluoroscopic imaging to visualize spinal canal anatomy across multiple regions.
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Service type: Diagnostic imaging procedure — myelography with contrast injection
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Typical site of service: Hospital outpatient department or ambulatory surgery center where fluoroscopic imaging and intrathecal contrast administration are performed
Data not available in the input for payers, taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with progressive lower extremity weakness, bilateral radicular leg pain, and intermittent bladder dysfunction presents for diagnostic evaluation. Prior MRI was inconclusive due to prior lumbar spinal instrumentation and suspected multilevel arachnoiditis. The interventional radiologist and neurosurgeon coordinate care: informed consent is obtained, allergy screening for iodinated contrast is performed, and coagulation status is reviewed. In the procedure suite (radiology fluoroscopy room), the patient is placed prone, lumbar sterile prep and local anesthesia are administered, and a lumbar puncture is performed. Contrast is injected and fluoroscopic myelography images are obtained covering two or more spinal regions (typically lumbar and thoracic). Radiological supervision and interpretation are provided in real time and finalized in a written report. Post-procedure monitoring occurs in recovery for vital signs and neurological assessment before discharge with post-myelography instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician interpretation/supervision separate from technical facility resources |
| 50 | Bilateral procedure | When the procedure involves distinct bilateral spinal approaches or documentation supports bilateral work (rare for myelography) |