Epidurogram w contrast

NJcoder

Expert
Messages
267
Best answers
0
Pt. had Lt transforaminal epidural steoid injection L5-S1 with Epidurogram.

I coded:

64483-lt
72275

my edit is asking for the contrast material code? does anyone know what code that may be?

thx
 

hewitt

Expert
Messages
390
Location
Manhattan, NY
Best answers
0
Sorry this is a long response, but Encoder Pro states, "This code should only be used when the images are documented and a formal report is issued. Procedure 72275 has both a technical and professional component. To report only the professional component, append modifier 26. To report only the technical component, append modifier TC. To report the complete procedure (i.e., both the professional and technical components), submit without a modifier. When performed at multiple levels of the spine (e.g., thoracic and lumbar spine), 72275 should be reported once for each spinal region examined (e.g., once for the thoracic and once for the lumbar regions). Report 72275 only when a formally interpreted contrast study involving multiplanar imaging generating "hard copy" images is performed. Do not report 77003 separately as 72275 includes fluoroscopic guidance and localization. For an injection procedure, see 62280-62282, 62310-62319, and 64479-64484. Radiology services are typically performed without anesthesia. In those rare instances where anesthesia is required, report 01935. Contrast media may be reported with Q9951 and Q9955-Q9967. Check with the specific payer to determine coverage."
 

aaron.lucas

Expert
Messages
286
Location
Cherry Hill, NJ
Best answers
0
Who are you billing for, and where was the service performed? If you're billing for a physician and the service was performed in an ASC or other facility, chances are you can't bill for the contrast at all. The only way would be if your doctor did it in his own office, or took the contrast with him/her to the facility. Remember supplies and things like that can only be billed by the person that owns/provides them. And I agree with the above that you need a formal radiology report to support an epidurogram. It's just like any other radiograph, the professional component requires "interpretation and report".
 

NJcoder

Expert
Messages
267
Best answers
0
Thank you...

The Epidurogram is was done by injection of Omnipaque contrast, total volume 4 ml, and it showed delineation of the nerve root, etc.

Does this warrant addl code 72275?
 

NJcoder

Expert
Messages
267
Best answers
0
This is an ASU case. Hospital setting. Maybe 72275 is not the correct code? It's an additional paragraph in the operative report for the Transforaminal Epidural Steroid Injection.
 

aaron.lucas

Expert
Messages
286
Location
Cherry Hill, NJ
Best answers
0
so are you billing just for the hospital (i.e. technical component, etc.) or is it global? there may be two issues here depending on the situation:

1) the findings are not in a separate report. by separate, we mean separate page and everything, it should look like it's own procedure by itself. since it's not separate I personally wouldn't bill anything besides the injection. fluoro includes injection of contrast, and at one time you would be able to bill fluoro but not anymore because it's included.

2) it was done in a hospital setting, which means chances are the hospital provided the contrast medium for injection, so only the hospital would be able to bill it, not the physician. does that make sense?
 

NJcoder

Expert
Messages
267
Best answers
0
it does make sense. it looks like the epidurogram was done after injection for diagnostic purpose...don't think I can bill 72275.

thx
 
Top