Wiki Intraoperative Fluoro

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kellit21

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I have a physician stating we should be coding for the intraoperative x-ray and fluoro. Here is what he has to say.....

at the hospitals, intraoperative fluoro is provided by a tech but the X-rays are not read by a radiologist. For these cases, I will dictate a detailed report and we should bill a professional component for the X-ray evaluation.
-for the surgery center, if there is no X-ray tech than we should bill for the technical and professional components. If there is a tech than we should bill only for the professional component.

I thought intraop fluoro and x-rays were included in the procedure performed. Can I please get some clarification?
 
In the ASC setting we are billing the TC component for the physically and the surgeon is billing for the PC on his professional bill. We have not had any problems with any payors. I believe this would be the case if the procedures were completed at the hospital as long as radiology does not review the film.
 
If you are referring to 76000, this is a "separate procedure" and if carried out as an integral part of another procedure coded cannot be used:

REFERENCE:

CHAP4-CPTcodes20000-29999_final10312017.doc
Revision Date: 1/1/2018
CHAPTER IV
SURGERY: MUSCULOSKELETAL SYSTEM
CPT CODES 20000-29999
FOR
NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL
FOR MEDICARE SERVICES

5. Fluoroscopy reported as CPT codes 76000 or 76001 shall not be reported with spinal procedures unless there is a specific CPT Manual instruction indicating that it is separately reportable. For some spinal procedures there are specific radiologic guidance codes to report in lieu of these fluoroscopy codes. For other spinal procedures, fluoroscopy is used in lieu of a more traditional intraoperative radiologic examination which is included in the operative procedure. For other spinal procedure codes, fluoroscopy is integral to the procedure.

20. Fluoroscopy (CPT codes 76000 and 76001) is an integral component of arthroscopic procedures when performed. CPT codes
76000 and/or 76001 shall not be reported separately with an arthroscopic procedure.
 
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