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62311 & 72775 denied

  1. Unhappy 62311 & 72775 denied
    Medical Coding Books
    27096 - paid
    77003 - paid
    62311 - denied as bundled to 27096
    72775 - denied as bundled to 62311 although 62311 was not paid

    pleas help...

  2. Red face
    Quote Originally Posted by coders_rock! View Post
    27096 - paid
    77003 - paid
    62311 - denied as bundled to 27096
    72775 - denied as bundled to 62311 although 62311 was not paid

    pleas help...
    72775 is not an active code. Hope this should be 72275, if so you can submit this claim with 59 modifier (as modifers are allowed to 62311 and 77033 per CCI edit)
    27096
    77003-59
    62311-59
    72275

    As you already got the payment for 77003, you can add 59 mod to 62311 only and refile the claim.
    Hope this helps

  3. #3
    Default
    Before adding 59 modifier , I would review 72275 was this diagnostic procedure, was a report provided for this. If you are going to bill 72275 and 77003 on the same claim was one a theurapetic injection and one diagnostic.

    I would run a report of how many times 72275 has billed in the past 6 months and review that the criteria is being met to bill this

    From CPT Assistant 2009
    Radiology/Diagnostic Radiology (Diagnostic Imaging)

    Questionuring various injections of therapeutic substances into the spine, contrast is often injected to ensure that the needle or catheter is in the epidural space. Is it appropriate to code72275, Epidurography, radiologic supervision and interpretation, in addition to the appropriate injection code?

    Answer:No. Code 72275 is only to be used when an epidurogram is performed, images documented, and a formal radiologic report issued. A statement indicating that contrast flows in the epidural space would only document localization and would not represent a diagnostic epidurogram. The introductory language in Surgery/Nervous System for Spine and Spinal Cord, under Injection, Drainage, or Aspiration in the CPT 2009 states that “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 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” (CPT 2009, p270).

  4. Thumbs down
    Quote Originally Posted by dwaldman View Post
    before adding 59 modifier , i would review 72275 was this diagnostic procedure, was a report provided for this. If you are going to bill 72275 and 77003 on the same claim was one a theurapetic injection and one diagnostic.

    I would run a report of how many times 72275 has billed in the past 6 months and review that the criteria is being met to bill this

    from cpt assistant 2009
    radiology/diagnostic radiology (diagnostic imaging)

    question:during various injections of therapeutic substances into the spine, contrast is often injected to ensure that the needle or catheter is in the epidural space. Is it appropriate to code72275, epidurography, radiologic supervision and interpretation, in addition to the appropriate injection code?

    Answer:no. Code 72275 is only to be used when an epidurogram is performed, images documented, and a formal radiologic report issued. A statement indicating that contrast flows in the epidural space would only document localization and would not represent a diagnostic epidurogram. The introductory language in surgery/nervous system for spine and spinal cord, under injection, drainage, or aspiration in the cpt 2009 states that “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 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” (cpt 2009, p270).
    no note was provided for this.

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