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Fluoro/ESI

Lori Posted Tue 27th of January, 2015 20:18:53 PM

I was reading the question previously posted regarding ESI and Fluoro for 2015. In it you were stating to follow the LCD because no additional articles could be found for the LCD and MLN. There was an article in your publications list "Spinal Procedures: Don't Be Fooled: ESIs and Transforaminals Aren't the Same
- Published on Mon, Dec 29, 2014" quoting Marvel Hammer about not billing it. So any updates?

SuperCoder Answered Thu 29th of January, 2015 13:46:02 PM

That article says that CMS will not allow, however still if your LCD says something different than it will override it. Also, different payers may have different perspective on it. Thanks !!

SuperCoder Answered Thu 05th of February, 2015 12:51:16 PM

Hi Lori- Please see the update below upon further review of your question.

After considering comments received, we are finalizing CPT codes 62310, 62311, 62318, and 62319 as potentially misvalued, finalizing the proposed RVUs for these services, and prohibiting separate billing of image guidance in conjunction with these services.

Lori Posted Wed 22nd of April, 2015 19:56:04 PM

I just saw a post from user id #72075 "62311 w/77003 bundled issue 4/1/15" and your response was to add -59 to 77003. Please clarify. -59 is for distinct procedural service. How is 77003 distinct? And your last response to me was that the separate billing was prohibited? So can we bill 77003 with and epidural injection 62310/62311?

SuperCoder Answered Fri 24th of April, 2015 04:50:47 AM

Code 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid]) includes localization of the needle or catheter and is used only for the spine and paraspinous area. Note that CPT® guidelines state that “ Injection of contrast during fluoroscopic guidance and localization [77003] is included in 22526, 22527, 27096, 62263, 62264, 62267, 62270-62282, 62310-62319)” as well as “Do not report 77002, 77003 in conjunction with 10030, 22586, 27096, 64479-64484, 64490-64495, 64633-64636, 0195T, 0196T, 0309T.” You’ll often report 77003 in conjunction with procedures such as 62267 and 62310-62319.

Please find below the link for better understanding:
https://www.supercoder.com/coding-newsletters/my-neurology-coding-alert/reader-question-heres-how-to-distinguish-77002-from-77003-142894-article

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