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Help with 62290 & 72295

  1. Unhappy Help with 62290 & 72295
    Clearnace Sale
    There is some debate here about whether you can code 62290 & 72295 together. Can they be billed together? Also, the way descriptor for 72295 looks, you can only bill it once not matter how many levels are done??? If anyone can please point me in the right direction I would greatly appreciate it. This is not a Medicare patient it's Aetna.

    Thank you!
    Susan, CPC-H

  2. #2
    North Carolina
    Per the AMA:

    If you performed this procedure on L2-3, L3-L4, L4-L5, & L5-S1 (example), you could report 62290 four times since four levels were imaged. Also, 72295 may be reported four times for the radiological supervision and interpretation as this code can be reported for each lumbar level.

    Reference: CPT Assistant April 2003
    Rebecca CPC, CPMA, CEMC

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  3. Smile
    thank you for posting so let me get this right, the 62290 is for the injection and the 72295 is what exactly for? the time for the physician performing the discogram? I guess I'm confused since this is for an ASC billing and I'm not understanding how we bill for physician interpretation since all services are included in ASC billing. Just need to get this straight for my own peace of mind.


  4. #4
    72295 is the radiological part of the procedure. The ASC would bill it with a -TC modifier and the physician would bill it with a -26 modifier.
    Walker Bachman, CPC, CPPM

  5. Default
    thanks Rebecca, that clarifies it for me.

    have a good day!!

  6. #6
    My name's not "Rebecca", but you're welcome anyway! LOL
    Walker Bachman, CPC, CPPM

  7. #7
    Twin Falls, ID
    Default 26 & TC billing of 72295
    Hello I am biling out a two level discography, my question is this:
    I'm billing from an ASC, can I bill 72295 with a 26 & TC for each appropriate NPI billed under?
    I don't know where to look for information regarding this information either, can someone point me in the right direction for clear guidance on this?
    Thank you in advance
    Jeffrey Parriott
    I just have no trust in the EMR we use, Athena so here is my billing scenario
    72295,26,xs*** reallyl not sure if the XS is applicable and I'm not getting good feed back from my system and I've never had good luck billing from both PRO & Fac side for imaging.

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