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Conventional Myelogram vs. Digital Subtraction Myelogram

Date: Jun 20, 2017

Question:

"First day, spinal needle was placed in thecal sac under fluoroscopic at L2-L3. A needle was placed over left pedicle of T10 vertebra. Omnipaque was injected to confirm subarachnoid position. 12 mL intrathecal Omnipaque was administered for biplane digital subtraction myelography centered at the thoracic level. Normal saline was then administered. Cervical, thoracic, and lumbar conventional myelographic images were then obtained. FINDINGS: Biplane fluoroscopy confirms appropriate position of the needle at the L2-L3 level. Digital subtraction myelography of the thoracic spine demonstrates no findings specific for CSF leak. Conventional myelographic images of the cervical, thoracic, and lumbar spine exhibit no findings specific for CSF leak (62305). CT post myelogram follows. Next day, repeat complete spinal myelogram (62305)." The conventional myelogram is documented as complete for both days, but the digital subtraction myelogram is thoracic (on first day), then cervical (on second day). Does this documentation warrant coding two complete myelograms for two sequence days?

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