62310 and 62311

Tsalomon

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In the descriptions of these codes it states "includes fluoroscopic guidance/localization". Does that mean that it has to be done under fluoroscopic guidance or localization in order to bill this code? My office wants to be 100% positive that the word "includes" means "has to be done".

Thanks so much for everyone help!
 

mhstrauss

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In the descriptions of these codes it states "includes fluoroscopic guidance/localization". Does that mean that it has to be done under fluoroscopic guidance or localization in order to bill this code? My office wants to be 100% positive that the word "includes" means "has to be done".

Thanks so much for everyone help!

Where are you seeing this notation? 62310/62311 do not currently include fluoro guidance, per the CPT book description.
 

Tsalomon

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The exact wording is INCLUDES “contrast injection during fluoroscopic guidance/localization”.

We are billing the 62311 but we are not preforming this injection under fluoroscopic guidance or localization. I just want to make sure that we are coding this injection properly.

Thanks so much!!!!!
 

JEYCPC

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The exact wording is INCLUDES “contrast injection during fluoroscopic guidance/localization”.

We are billing the 62311 but we are not preforming this injection under fluoroscopic guidance or localization. I just want to make sure that we are coding this injection properly.

Thanks so much!!!!!

My book says "includes contrast for localization when performed" no fluoroscopic guidance mentioned. However it does say when performed. So I take that to mean it doesn't HAVE to be done.
 

mhstrauss

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I agree with the reply above, that due to the wording "when performed", from a coding standpoint, fluoro guidance is not required to bill these 2 codes. However, you need to also check payer coverage policies--I've seen several that will consider an ESI not medically necessary if fluoro guidance and/or contrast are not used. See this example from the attachwed link below:

CMM-200.2 General Guidelines
An epidural steroid injection without the use of fluoroscopic guidance and the injection
of a contrast is considered not medically necessary, with the exception of an emergent
situation or when fluoroscopy or the injection of contrast is contraindicated.

http://www.medsolutions.com/cignagu...CMM-200 Epidural Steroid Injections_Clean.pdf

HTH!!
 
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Code 62310- Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic
If what I understand is correct, these codes doesn't says about fluoroscopic guidance, so if there is a fluoroscopic guidance stated in chart you have to code guidance code separately.
 
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