77003 w/ 62310 or 62311

Jamie Dezenzo

True Blue
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Mishawaka, IN
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Hi All,
Want to verify if it would be correct to bill 77003-TC w/ CPT 62310 or 62311?
CPT states "injection of contrast during fluro guidance and localization (77003) in included 62310-62319.

Thanks!
 

SS62

Networker
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North Wales, PA
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I thought you could not bill for 77003 in ASC? Is Mcare bundling this? and/or can we also bill other commercial payors? Thanks
 

mbort

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ENGLEWOOD/DENVER
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for Medicare the 77003 has an N1 payment indicator therefore they do not pay. Most commercial payors will pay this based on your contracts.
 

csnow

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Read the CPT book carefully

We had a discussion today about this. The CPT description says "Injection of contrast during guidance and localization(77003) is included in codes XXX.

This needs to be read carefully and it helps to know the history of the remark. Some providers used to squirt just a little contrast during the procedures noted above and then try to bill for a epidurogram, 72275. This was seriously over-coding!

Therefore, the notation aboves says "if you use a little contrast during flouro guidance, don't code the epidurogram." It does not say Fluoroscopic guidance is included in the codes noted above.

If you don't believe me look at CPT Assistant, AHIMA or Dr. Z's Interventional Radiology Coding Guide. Better yet, use those documents for your appeals!
 

diann

Networker
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77003/62310-62311

For the ASC facility you'll use the TC modifier. Thanks for the info on the contrast and epidurography. That's good to know and to use for further discussion!
Thanks
Diann Do Bran CPC, CPC-H
 
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