Radiology Coding Alert
Know When to Separately Report Fluoroscopic Guidance
Question: A radiologist in our practice performed fluoroscopic guidance for a diagnostic lumbar spine puncture of a patient. The spinal puncture was reported with 62270, but we didn’t include +77003 since the guidance is included in the spinal puncture code. The radiologist is saying we should report the guidance. Should we report +77003 with 62270? Colorado Subscriber Answer: You should actually report only 62328 (Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance) instead of 62270 (Spinal puncture, lumbar, diagnostic). Code 62270’s descriptor doesn’t explicitly state that fluoroscopic guidance is included, but 62328’s descriptor does. At the same time, a parenthetical note in the code set instructs you to not report 62270 or 62328 with +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)). You’ll find a similar note with +77003. If you were to report the procedure with 62270 and +77003, there is a chance the claim would be denied.
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Know When to Separately Report Fluoroscopic Guidance
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