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Question: We have a radiology report where the radiologist performed fluoroscopy during a procedure for one hour and 45 minutes. The descriptor for CPT^® code 76000 states “up to 1 hour.” Do we report multiple units of 76000 for the fluoroscopy?

Pennsylvania Subscriber

Answer: No, you won’t report multiple units of 76000 (Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time) for the fluoroscopy procedure lasting longer than an hour. According to a 2019 CPT^® Assistant, you’ll append modifier 22 (Increased procedural services) to the code to indicate the provider performed the procedure for more than 60 minutes.

The instruction from CPT^® Assistant followed the deletion of code 76001 in 2019.

During fluoroscopy, the provider passes a continuous X-ray beam through the body to visualize the patient’s internal body structures. The provider can view the images on a monitor, so the physician can evaluate the structures in real time.

Pay attention: While 76000’s descriptor states the procedure can be performed separately, the provider might not be able to report it separately if a related procedure includes an imaging service. For example, 93453 (Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed) inherently includes an imaging service.

The National Correct Coding Initiative (NCCI) edits bundle 76000 into 93453, which means you can’t report fluoroscopy separately unless the imaging is performed with an unrelated procedure. In that case, you may report 76000 separately by appending the code with modifier 59 (Distinct procedural service) or XS (Separate structure, a service that is distinct because it was performed on a separate organ/structure) depending on the payer.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC