Wiki Epidural Steroid Injections - WONDERING FOR EPIDURAL

[mad_one80]

WONDERING....FOR EPIDURAL STEROID INJECTIONS (EX: CPT 62311) DOES THIS INCLUDE THE FLUO GUIDANCE(CPT 77003) ALSO? THE CPT STATES "Injection of contrast during fluoroscopic guidance and localization is an inclusive component of.....62310-62319"

this means that the contrast injection is included, not the fluo guidance, right? some insurances have paid on some claims and reject other claims(same ins carriers processing) as inclusive...even when appealed, some claims are paid and others stay rejected! (again, same exact cpt codes appeal to the same ins carriers with different results!!)

 

[pinnaclephyserv]

Use this appeal letter and you can go to the ASA and they have a standard letter. They CAN NOT deny 77000, 77002, or 77003 with any spinal injections.


Re: Code 76005

Attention Review Department

Attached are claim resubmissions for fluoroscopy code 76005-26. Per CMS, Fluoroscopy is not inclusive to the injection procedures done by physician, as described in the CMS directives. The professional component of fluoroscopy is guidance of a needle to the correct location of site to be injected for pain relief. Without the fluoro guidance, the injection may or may not be beneficial to the patient, and therefore, would create more procedures as well as pain to the patient.

We believe that using the fluoro guidance benefits the patient, as well as insurance carriers. The patient gets the safest and most effective treatment and the insurance carriers are spared additional treatments and expense.

Please reprocess our claim for the fluoroscopy code.

Thank you for your consideration and time in this matter.

 

[mbort]

fluoroscopy is codable with 99% of the pain codes...(its the injection of contrast that bundles).

 

[mad_one80]

Use this appeal letter and you can go to the ASA and they have a standard letter. They CAN NOT deny 77000, 77002, or 77003 with any spinal injections.


Re: Code 76005

Attention Review Department

Attached are claim resubmissions for fluoroscopy code 76005-26. Per CMS, Fluoroscopy is not inclusive to the injection procedures done by physician, as described in the CMS directives. The professional component of fluoroscopy is guidance of a needle to the correct location of site to be injected for pain relief. Without the fluoro guidance, the injection may or may not be beneficial to the patient, and therefore, would create more procedures as well as pain to the patient.

We believe that using the fluoro guidance benefits the patient, as well as insurance carriers. The patient gets the safest and most effective treatment and the insurance carriers are spared additional treatments and expense.

Please reprocess our claim for the fluoroscopy code.

Thank you for your consideration and time in this matter.

thx so much!!!