CPT 72240 Cervical Myelogram Reimbursement | OpenPayer

Summary & Overview

CPT 72240: Cervical Spine Myelogram Imaging Supervision and Interpretation

CPT code 72240 designates the imaging supervision and interpretation component of a cervical spine myelogram, a diagnostic procedure in which contrast material is injected and X‑ray images are obtained to assess the spinal canal and its contents. This code is specific to the cervical (neck) region and is reported only for the imaging supervision and interpretation portion of the myelogram procedure. Nationally, accurate reporting of this code matters for appropriate claim adjudication, separation of professional and technical components, and consistent clinical documentation.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and common billing modifiers associated with imaging supervision and interpretation. The publication also outlines benchmark and policy considerations relevant to payers and providers, clarifies service-line classification for radiology and diagnostic imaging teams, and highlights areas where documentation must support reporting of an imaging-only service. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare72240CPTmyelogramcervical spinediagnostic imagingradiologyimaging supervisioninterpretationoutpatient imaging

Billing Code Overview

CPT code 72240 represents imaging supervision and interpretation for a cervical spine myelogram. The procedure involves injection of contrast material into the cervical spinal canal followed by a series of X‑ray images to evaluate the spinal canal and its contents for injury, compression, or abnormal growth. This code is reported to represent only the imaging supervision and interpretation component of a cervical myelogram.

Service type: Diagnostic imaging supervision and interpretation for myelography
Typical site of service: Hospital radiology department or outpatient imaging center

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with progressive neck pain, radicular symptoms into the right upper extremity, and inconclusive MRI due to prior cervical hardware is referred for a cervical myelogram. The outpatient procedural workflow: the patient arrives to the radiology fluoroscopy suite or hospital radiology department; informed consent is confirmed and allergies reviewed; the patient is positioned; a neuroradiologist or interventional radiologist (or spine surgeon in some settings) performs lumbar or cervical cerebrospinal fluid access and fluoroscopically guides intrathecal injection of iodinated contrast; dynamic fluoroscopic and spot radiographic images are obtained of the cervical spine to evaluate spinal canal stenosis, nerve root impingement, or CSF flow obstruction; the interpreting physician documents supervision and interpretation of the imaging series and provides a written radiology report. Billing for 72240 represents only the imaging supervision and interpretation component of the cervical myelogram; technical resources such as contrast administration, fluoroscopy equipment, and technologist time are billed separately (e.g., technical component TC may apply). Typical sites of service are the hospital radiology department, ambulatory surgery center, or specialized outpatient imaging center. Typical patient scenario includes preoperative evaluation for multilevel cervical stenosis, evaluation of postoperative persistent neurologic deficits when MRI is contraindicated or non-diagnostic, or assessment of suspected intradural lesions or arachnoiditis.

Coding Specifications

Modifier	Description	When to Use

Related Codes

CPT-72195-PELVIC-MRI-WITHOUT-CONTRAST

CPT 72195: Pelvic MRI, Without Contrast

CPT-72149-LUMBAR-SPINE-MRI-WITH-CONTRAST

CPT 72149: MRI Lumbar Spinal Canal and Contents with Contrast

CPT-72100-LUMBOSACRAL-SPINE-XRAY-2-3-VIEWS

CPT 72100: Lumbosacral Spine X‑Ray, 2–3 Views

CPT-72120-LUMBOSACRAL-SPINE-BENDING-VIEWS-RADIOGRAPH

CPT 72120: Lumbosacral Spine Radiographs, Flexion/Extension Views

CPT-72130-THORACIC-SPINE-CT-WITH-AND-WITHOUT-CONTRAST

CPT 72130: Thoracic Spine CT, Without and With Contrast

CPT-72127-CT-CERVICAL-SPINE-WITH-AND-WITHOUT-CONTRAST

CPT 72127: CT Cervical Spine, Without and With Contrast

CPT-72050-CERVICAL-SPINE-XRAY-4-5-VIEWS

CPT 72050: Cervical Spine X‑ray, Four to Five Views

CPT-72190-PELVIC-RADIOGRAPHY-THREE-VIEWS

CPT 72190: Pelvic Radiography, Minimum Three Views

CPT-72040-CERVICAL-SPINE-XRAY-2-3-VIEWS

CPT 72040: Cervical Spine X‑Ray, 2–3 Views

CPT-72129-THORACIC-SPINE-CT-WITH-CONTRAST

CPT 72129: CT Thoracic Spine with Contrast

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Taxonomy Code	Specialty	Notes
207RH0000X	Radiology — Diagnostic Radiology	Neuroradiologists and diagnostic radiologists commonly perform and interpret cervical myelograms.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M48.02`	Spinal stenosis, cervical region	Cervical myelogram evaluates degree and location of spinal canal narrowing affecting the cervical cord.

| G95.20 | Noninfective myelopathy, unspecified | Used when myelographic imaging is performed for cord dysfunction of unclear etiology.

| M50.12 | Other cervical disc displacement, mid-cervical region | Myelography helps define impingement of nerve roots or thecal sac by displaced disc material.

| G96.11 | Cerebrospinal fluid leak, cranial | Myelography can be used to localize CSF leaks or evaluate CSF flow abnormalities.

| M13.9 | Disorder of cervical intervertebral disc, unspecified (Note: commonly coded as M50.x series) | Cervical myelogram is used in disc disease evaluation; coders should select the specific M50 code when possible.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`62284`	Injection(s), of diagnostic or therapeutic substance (e.g., anesthetic, corticosteroid), not including neurolytic substances, including needle or catheter placement, with image guidance (fluoroscopy or CT); cervical or thoracic, single level	May be performed prior to or as part of procedures evaluating cervical pathology; related when diagnostic injections are used for localization.

| 72020 | Radiologic examination, spine, cervical; 2 or 3 views | Often performed as preliminary radiographs prior to myelogram to document alignment or hardware and as part of imaging series.

| 72270 | Myelography, thoracic, including imaging supervision, interpretation, and radiographic documentation | A related myelography code for thoracic level; used in similar clinical workflows when different level is studied.

| 72100 | Radiologic examination, spine, cervical; 1 view, separate and distinct from myelogram technical services | Basic radiographic views that can accompany or precede myelography.

| 99152 | Moderate sedation services provided by the same physician performing the diagnostic or therapeutic service, first 30 minutes intra-service time reported (example code for moderate sedation — verify payer rules) | May be reported if moderate sedation is provided during myelogram per payer guidelines (note: sedation coding varies by payer).