72275 with 76000
I also have a question in regards to CPT 72275-59 (Epidurography) billed with CPT codes 64483, 76000-59, 77002, J0702, and 94760.
I'm looking at a record where our Physician is billing the above codes and I've hit a wall in understanding 2 pieces of the codes/records. Below are my 2 questions.
I get that 77002 is not the correct CPT code for Fluoro (which is inclusive of 64483) and that 77003 should have been billed even though it will deny as inclusive.
But the Doc is also billing 76000 (Stand alone fluoro) and 72275. 77003 is bundled into 72275, but he's billing 76000-59 which is odd and it's bypassing the carriers edits. (Why would he bill this?? ) So that's issue #1, and if anyone can explain why he'd be doing this and if it's possibly ok, I'd appreciate it. If it's not ok, why? (Any AMA driven material would be awesome!)
Question/issue #2: In his Epidurography report, it ONLY states the following:
"1 cc of 240 lohexol and 1 cc of air was injected and seen to spread in a typical epidural fashion fluoroscopically. The flow of the lohexol was seen on the Epidurography. This graph was used to confirm proper placement."That's it. Is that enough to warrant an Epi? Doesn't it sound like it really was mainly for the needle placement of the injection? (64483) No mention of the images being documented/stored, so I'm leery of this. Anyone have any solid advice as to whether they'd allow this or give feedback to the Physician that he's not documenting enough?
THANK YOU so very much for anything you guys could help with!
Last edited by beckipoff; 04-10-2013 at 02:16 PM.
Becki, CPC, CPMA, CGIC, CHONC, CPCD