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Anesthesia Coding Alert

READER QUESTIONS:

Billing an Epidural With Fluoroscopy

Published on Tue Feb 08, 2005

Question: Can we report fluoroscopy with 62311 for an epidural injection?

Washington Subscriber
Answer: This is a common question because different sources seem to have conflicting guidelines. The bottom line is, yes, you can bill fluoroscopy (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 (62311, Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]).

Part of the confusion can be attributed to the guidelines in CPT's Spine and Spinal Cord section of the nervous system codes. The explanation lists several groups of codes (including 62311) that include the injection of contrast during fluoroscopic guidance and localization. However, this means that the contrast is bundled, not the fluoro and injection procedures themselves.
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