Wiki Nexplanon removal w/Fluoroscopic guidance

amyjpaine

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My provider performed a difficult malpositioned Nexplanon removal under fluoroscopic guidance in the OR after a failed attempt in the office. Does anyone have experience with this situation? I have billed surgeries with ultrasound guidance, but never fluoroscopic guidance. I am thinking 11982 and 77002-26. Any advice?
 
77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)
Notes:
(Use 77002 in conjunction with 10160, 20206, 20220, 20225, 20520, 20525, 20526, 20550, 20551, 20552, 20553, 20555, 20600, 20605, 20610, 20612, 20615, 21116, 21550, 23350, 24220, 25246, 27093, 27095, 27369, 27648, 32400, 32405, 32553, 36002, 38220, 38221, 38222, 38505, 38794, 41019, 42400, 42405, 47000, 47001, 48102, 49180, 49411, 50200, 50390, 51100, 51101, 51102, 55700, 55876, 60100, 62268, 62269, 64400-64448, 64450, 64455, 64505, 64600, 64605)
While 77002-26 seems fairly accurate, it is specifically an add on code. 11982 is not a base code for 77002, so it should not be used.

76496 Unlisted fluoroscopic procedure (eg, diagnostic, interventional) is likely your best option. As with any unlisted code, be prepared to write an appeal letter and reference a comparison code (77002)

Another option would be to use only 11982 with modifier 22. This too, will likely require an appeal letter
 
Thank you, Christine! I appreciate you taking the time to respond. The info I was reviewing only listed other codes NOT to bill with 77002, so this is helpful! Thank you!
 
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