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Radiology Coding Alert

You Be the Coder:
Can We Report Fluoro With Epidural?

Question: Your September article "Five Steps to Fluoroscopy Reimbursement" indicated that we can separately report both fluoroscopy and epidural injections. But CPT Includes a statement directly following code 76005 that says the injection of contrast during fluoroscopic guidance is included in codes 62310-62319. How should we report the fluoroscopy if CPT Codes says it's included in the epidural injection?

Minnesota Subscriber

Answer: As we reported in our September issue, the National Correct Coding Initiative has no edits barring practices from reporting 76005 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) with the epidural injection codes 62310-62311.
 
Unless your carrier specifically advises against it, you should continue to report these services together unless you receive direction to the contrary.
 
The CPT quote that you reference states that the "injection of contrast" is included in the epidural codes.  This means that you cannot separately report an injection code such as 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous) to represent the contrast injection. You can, however, still report the fluoroscopy itself, along with the appropriate epidural injection code.