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cpt 77003 denied for bundling to 62311

Renee Posted Mon 15th of July, 2013 13:58:11 PM

i am getting denials now on 77003 code when billed with 62311 the last printed information i have from the ama is that the codes MAY be separately reported and are separetely payable. can you help with clarification and links to information. thank you.

SuperCoder Answered Mon 15th of July, 2013 21:46:07 PM

You can report fluoroscopic guidance with interlaminar epidural blocks.

Remember: Report an interlaminar epidural injection just as you would a single epidural injection. Code the procedure based on the injection location, with either 62310 (Injection[s], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic) or 62311 (… lumbar, sacral [caudal]).

The use of the phrase “includes contrast for localization” in the code definition can cause confusion, but revised guidelines introduced in CPT® 2012 state, “Fluoroscopy (for localization) may be used in the placement of injections reported with 62310-62319, but is not required. If used, fluoroscopy should be reported with 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid]).”

Caution: The descriptors for some injection procedures include fluoroscopy, so in those instances you won’t separately report 77003. For example, codes 64490-64495 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT] …) include fluoroscopic or CT guidance.

If the service takes place in a facility, append modifier 26 (Professional component) to 77003 to indicate you’re reporting only the physician’s work and not the technical component. Your provider’s documentation should briefly state that he used fluoroscopy for needle guidance.

Per CPT Assistant July 2012; Volume 22: Issue 7 :Fluoroscopy may or may not be used to identify specific spinal anatomy in the placement of injections reported with codes 62310-62319. When used, fluoroscopy (for localization) may be reported with code 77003. If epidurography is used for localization, report code 72275.

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