Anesthesia Coding Alert
Watch Anatomic Location for Difference Between +77002 and +77003
Question: I have multiple questions about fluoroscopy codes +77002 and +77003. What is the difference between them? Is the difference based on the treatment site location or the site where the provider injects the contrast? Also, is +77003 only for the spine and +77002 for all other body areas? Missouri Subscriber Answer: Both codes in question represent fluoroscopic guidance only. The “primary procedure” referenced in both descriptors typically refers to the injection of contrast. Code +77002 (Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)) represents needle placement but is not specific to a particular body area. This code does not include the injection procedure. You’ll typically report +77002 with major joint injections (such as 20610, Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance) or other peripheral injections. Code +77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure)) includes localization of the needle or catheter and is used only for the spine and paraspinous area. Note that CPT® guidelines state, “Do not report guidance codes +77001, +77002, +77003 for services in which fluoroscopic guidance is included in the descriptor.” The guidelines do specify several codes you can report in conjunction with +77003. These include:
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