spinal puncture with epidural injection


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Hi Radiology Coders
I have a question. Can you bill both an 62270 (spinal puncture) with a 62273 (injection, epidural, of blood or clot patch together. I received a denial stating that 62273 cannot be billed because it falls under standards of medical/surgical practice. The Medicare CCI edit book states it can be billed with a modifier.

Can it be billed with a modifier, if so, what modifier, and if not, can you tell me what the standard rule on this is?

Thanks so much
ClaudiaK, CPC


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Are the 2 being done for different reasons? It looks like they are billable together with a modifier, but my thinking is if they're done at the same session for the same reason, that I would just do the 62273...to me it sounds like the spinal puncture needs to be done to do the 62273. I don't code these on a regular basis, so i'm not 100%.

here's the description of 62273:

This procedure is performed following a spinal puncture to prevent spinal fluid leakage. The patient remains in a spinal tap position. The patient's blood is injected outside the dura to clot and plug the wound, preventing spinal fluid leakage. The wound is dressed and monitored.

Injection of contrast during fluoroscopic guidance and localization is an inclusive component of codes 62263-62264, 62270-62273, 62280-62282, 62310-62319, 0027T. Fluoroscopic guidance and localization is reported by code 77003, unless a formal contrast study (myelography, epidurography, or arthrography) is performed, in which case the use of fluoroscopy is included in the supervision and interpretation codes.

(per Ingenix Encoder)