Orthopedic Coding Alert

Question: What is the difference between 76000 and 0054T, and when should I use them?

Texas Subscriber Answer: The difference between 76000 (Fluoroscopy [separate procedure], up to 1 hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) and +0054T (Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image guidance based on fluoroscopic images [list separately in addition to code for primary procedure]) is the type of equipment the orthopedist uses.

For 0054T, the physician uses a computer with an optical or electromagnetic sensor to track surgical instruments, according to the AMA's CPT Changes 2007: An Insider's View. The computer uses stored images to display the position of the surgical instruments and the devices- predicted path. -This allows the physician to optimally place implants through minimal incisions,- CPT Changes says.

If your orthopedist uses the C-arm only to view the anatomy, you should instead report 76000, assuming you aren't just taking a -quick look,- but are instead using the C-arm for a medically necessary reason to evaluate joint motion or structure. This is not as involved as 0054T, during which the physician uses the imaging and computer much more extensively.