Coding for cerebrospinal fluid flow imaging

Q.

My doctor did what he called a “nuclear cisternogram” with injection of radiopharmaceutical through a lumbar puncture into the CSF. How is this coded? 

A.

Look at CPT^® codes 78630 for the nuclear cisternogram along with CPT code 62323 for the injection. If billing the technical component, also add the appropriate Level ll HCPCS code for the radiopharmaceutical injected. The codes and full descriptions are:

78630 Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography

62323 Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT)