62290: coding guideline

kovacs

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when using the 62290 code do you list individual levels within the lumbar or code it multiple times within each area(lumbar)with each single level
 

mbort

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62290 is to be coded for each level that the procedure is performed. I would separate them out on individual line items and apply the 59 modifier as indicated.
 

dwaldman

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The diagnosis seems to be based on the results of the discogram such as a final report describing for example the disc appears to have annular tears (M51.36/M51.37) or there appears to be disc displacement (M51.26/M51.16/M51.26/M51.27). Or one or two of the discs have pathology and the other discs are normal in appearance. The physician typically would state a pre-operative and post-operative diagnosis, If the disc are normal and the reason for the test was radiculopathy (M54.16/M54.17) then the sign or symptom that prompted the test would be reported when there is not a definitive diagnosis that was reached.
 

kelly.armstrong

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Billing 77003 with 62290?

Hello,

I recently started billing Discograms, 62290. I am billing Fluoroscopic Guidance code 77003 with it, using modifiers 59, 26. 77003 is getting denied by Novitas. Denial reason is "The procedure is inconsistent with the modifier used or a required modifier is missing".

I referred to the list of Eligible Surgical Modifiers from the Novitas website and 26 is not listed, I think I need to remove the 26.

How are others billing the Fluoroscopic Guidance with 62290?

Thanks,

Kelly, CPC
 

mhstrauss

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Hello,

I recently started billing Discograms, 62290. I am billing Fluoroscopic Guidance code 77003 with it, using modifiers 59, 26. 77003 is getting denied by Novitas. Denial reason is "The procedure is inconsistent with the modifier used or a required modifier is missing".

I referred to the list of Eligible Surgical Modifiers from the Novitas website and 26 is not listed, I think I need to remove the 26.

How are others billing the Fluoroscopic Guidance with 62290?

Thanks,

Kelly, CPC

26 is allowed with 77003; we bill this every day (although not for disco procedures). I would list it before the 59 though, if warranted.

I do agree that 77003 should not be billed with 62290.

The only other thing we bill with 62290 is 72295-26 for rad S&I, per notation right beneath 62290 in the CPT book.
 

kelly.armstrong

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26 is allowed with 77003; we bill this every day (although not for disco procedures). I would list it before the 59 though, if warranted.

I do agree that 77003 should not be billed with 62290.

The only other thing we bill with 62290 is 72295-26 for rad S&I, per notation right beneath 62290 in the CPT book.

Thanks so much! I see the notation now for 72295. I don't know how I missed that before. I appreciate your help!

Kelly
 
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