Fluoroscopic guidance is not included in the code; when used, it is reported separately (see 77003). According to the lay description in the Coder's Desk Reference, it does require this guidance, however. In my experience coding for Physical Medicine/Rehab, they always use guidance to ensure proper placement of the injection. When done in the OP department of a hospital or in a free-standing surgery center, you would use modifier 26 on the guidance code since the facility will bill for the equipment.
Hope this helps,
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