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Anesthesia Coding Alert

READER QUESTIONS:

Carriers Bundle Fluoro With 63650

Published on Tue Nov 01, 2005

Question: What code do I use for a pars defect injection (L5) under fluoroscopy? The physician administered 1 percent Lidocaine for local anesthetic, then 1 cc of 0.5 percent Bupivacaine and 20 mg of Depo-Medrol for the actual treatment. 


Delaware Subscriber
Answer: Your Medicare carrier is following the National Correct Coding Initiative's (NCCI) guidelines. NCCI edits include fluoroscopy (such as 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 most pain procedures (such as 63650, Percutaneous implantation of neurostimulator electrode array, epidural).

Carriers bundle these services because the physician cannot perform the procedure without fluoroscopy.
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