Leorah Posted Sun 16th of February, 2020 09:56:05 AM
Our practice performs many lumbar puncture procedures under fluoroscopy. We usually code this procedure with a 62270 for the lumbar and 77003 for the fluoroscopy. Lately we have noticed that the insurance companies are not paying for the 77003 code. We noticed that there is a new code that has come out in 2020 that encompasses both the fluoroscoy and lumbar puncture in one code. This is 62383. The problem is that Medicare has not come out with pricing on this code and as not approved it yet. Are we supposed to use this code? Since we are not getting paid for the fluoroscopy.
SuperCoder Answered Mon 17th of February, 2020 02:51:46 AM
CPT code 62328 (NEW code for 2020) should be the code of choice when it comes to coding for diagnostic lumbar puncture under fluoroscopic or CT guidance. As per 2020 updates from AMA, this code should be billed alone. CPT code 77003, that was being reported earlier with CPT code 62270 cannot be reported now as per the latest AMA guidelines.
Per AMA, (Do not report 62270, 62328 in conjunction with 77003, 77012).
CPT code 62328 is Medicare payable. As per physician fee schedule for Q1, 2020, CPT code 62328 has been assigned $93.47 (National value) in a non-facility setting and $267.06 (National Value) in facility setting.
Hope provided information would be helpful.