• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

spinal puncture with epidural injection


Best answers
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


Best answers
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)