I, too, had issues with CPT's statement. I found this article and found it helpful. As of yet, I haven't had any denials for 77003.
1. CPTÂ® provides for separate and distinct reporting
According to the introductory notes to the spinal injection section of the Current Procedural Terminology (CPTÂ®) book,
“Injection of contrast during fluoroscopic guidance and localization is an inclusive component of codes 62263, 62264, 62267, 62270-62273, 62280-62282, 62310-62319. Fluoroscopic guidance and localization is reported with 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.” (Emphasis added.)
Although injection of contrast is an inclusive component of the spinal injections listed, fluoroscopic guidance is not. The CPTÂ® text above clearly establishes that it is correct to report both the fluoroscopic guidance and the pain procedure when the procedure is done under fluoroscopy. Only the injection of contrast is bundled.
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