Neurosurgery Coding Alert

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Fluoroscopic Guidance

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Question: How should we report fluoroscopic guidance during spinal surgery? Should we use 76001 for each hour beyond the first? Are any modifiers necessary? Michigan Subscriber     Answer: The appropriate codes to report fluoro-scopic guidance during spinal surgery are 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) and 76001 (Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician [e.g., nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy]). Code 76001 is not an add-on code; rather it describes physician time of more than one hour you should not report 76001 more than once per session while 76000 describes physician time up to one hour. Therefore, if the physician spends 45 minutes, 76000 is appropriate. If the physician spends one hour 20 minutes, 76001 is appropriate. If the physician spends two hours, 40 minutes, 76001 is correct, and so on. Modifier -51 (Multiple procedures) is not necessary when reporting 76000/76001, but you should append modifier -26 (Professional component) if the surgeon only interprets the results of the fluoroscopy or performs the procedure in a hospital facility or using equipment that he or she does not own.
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