Below is from WPS Medicare J5 LCD for epidurals.
The CPT code 72275 (Epidurography, radiological supervision and interpretation) differs from CPT code 77003 in that it represents a formal recorded and reported contrast study that includes fluoroscopy. Epidurography should only be reported when it is reasonable and medically necessary to perform a diagnostic study. Epidurography should not be billed when the contrast injection is part of the fluoroscopic guidance and contrast injection to confirm correct needle placement that is integral to the epidural, transforaminal and intrathecal injections addressed in the policy.
Below is from AMA CPT Assistant 2010
February 2010 page 12
Radiology: Radiologic Guidance, 72275, 77003 (Q&A)
Question: What is the difference between CPT codes 72275, Epidurography, radiological supervision and interpretation, and 77003, Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, or sacroiliac joint), including neurolytic agent destruction?
Answer: Code 72275 (epidurography) differs from code 77003 (fluoroscopic guidance) in that it represents a formal contrast study that includes fluoroscopy. Code 77003 represents fluoroscopic guidance and localization used in spine or paraspinous injection procedures, so it is reported in addition to the code for the injection procedure when the injection procedure does not include fluoroscopic guidance. It is inappropriate to report code 77003 in addition to code 72275.
While these localization or radiological supervision and interpretation codes are not add-on codes, typically another service is reported by the same or another physician. This is because they do not include the injection services (eg, code 62310 for the injection component of cervical epidurography or 62281 for the therapeutic epidural injection). However, the injection of small amounts of contrast to assist in the localization services described by 77003 is not separately reported. Rather it is part of the service for the injection of the diagnostic or therapeutic substance for which localization is required.
