In this paper, we propose the lossless coding: scheme for progressive transmission of medical images. The input image is decomposed by the proposed fast adaptive subband decomposition method which is suited for a lossless coding. The decomposed images are coded by an arithmetic coder with two conditioning pixels, and the conditioning pixels are selected differently according to the property of the subbands. The conditioning contexts are usually quantized to reduce the conditional state, and the optimization method of quantization is proposed For the purpose of improving compression ratio in this paper. The proposed lossless coding scheme provides the asymmetric structure of cosec and results in better compression ability than the JPEC lossless coding[ 1 ].