What do you mean is fluoroscopic guidance "mandatory"?
If it was performed, then yes capture 77003.
If it was not performed then you would not bill the fluoroscopic guidance code.
Using Encoder Pro, when you open the page for 64622 and scroll down to the "Instructions" section it says "Radiology crosswalk 77003".
I am a little unclear on what your question is, but I hope this information helps.
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