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Thread: 72275 denied

  1. #1

    Question 72275 denied

    AAPC: Back to School
    72275 was denied as bundled to 62311. Does anyone know the guidelines for billing thesed two CPT codes together?

  2. #2
    Join Date
    Apr 2007


    The CPT code 72275 (Epidurography, radiological supervision and interpretation) differs from CPT code 77003 in that it represents a formal recorded and reported contrast study that includes fluoroscopy. Epidurography should only be reported when it is reasonable and medically necessary to perform a diagnostic study. Epidurography should not be billed when the contrast injection is part of the fluoroscopic guidance and contrast injection to confirm correct needle placement that is integral to the epidural, transforaminal and intrathecal injections addressed in the policy.


    I agree the edit is confusing, it makes you wonder how you report a epidurogram with Medicare. Above the LCD from WPS Medicare J5 for epidurals explains the differences in fluoro and epidurography codes, but they don't explain if 72275 can be at the same level with 59 relaying it was for diagnostic purposes instead of needle guidance. Nothing is in the NCCI policy manual. Sorry I don't know because I can't find what their stance is when the 59 would be appropriate.

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