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72275 Epidurography

  1. Unhappy 72275 Epidurography
    Medical Coding Books
    Hi- can someone help me with a serious problem!!!!
    I started working for a pain management dr. last April of 2007. Prior to that time the dr was using an outside billing service. They were billing 72275 without mod 26 and was getting pd for it. I thought mod 26 was necessary since he is the professional and the radiologist would be for the TC. the dr. is concerned because his revenue has decreased from 72275 26. Do I have to use the mod26 if he is controling the C-Arm and use the x-ray as a guild?
    Toni, CPC,CCP

  2. #2
    Lafayette, LA
    modifier 26 is needed for 72275. Just be sure your MD documents the use of the equipment and findings.

  3. Default
    THANKS Belinda
    Last edited by tadavis; 10-08-2007 at 02:09 PM. Reason: name change

  4. #4
    The first question to ask is "who owns the C-Arm, then who operates it?" If the pain dr. owns and operates the C-Arm, and dictates for the epidurography, then you can bill globally. How is the radiologist involved?

  5. Default
    the c-arm belong tothe hospital but the physician said he is the one that controls the c-arm--I asked the radiology department did they bill for the tc but hey said no--there is no formal report but an image is taken (hard copy)

  6. #6
    Since the C-Arm is owned by the hospital, the physician cannot bill for the TC. There would also need to be a formal report for the 72275 to be billed or you should use another code, most likely 77003.

  7. #7
    Post 72275 Epidurgram
    How many times a day can we bill the Epidurgram? Do anyone have some literature pertaining to how many times we can bill this code?

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