# Billing Injections with Fluoroscopy



## meggz21 (Oct 10, 2008)

If the physician gives a 27096 sacroiliac injection and a 64475/64476 lumbar/sacral injection at the same visit using fluoroscopy, would he be able to bill 77003 fluoroscopy twice? I'm a little confused if this would be paid twice. Has anyone ever encountered this?


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## magnolia1 (Oct 10, 2008)

It is okay to report the Fluoroscopy for each region that an injection is given

Please refer to the June 2008 CPT Assistant below:

*Code 77003 *

In contrast to code 77002, spine and paraspinous anatomic sites are specified in the descriptor of code 77003, Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint), including neurolytic agent destruction. Code 77003 describes fluoroscopic guidance of spinal or paraspinal injections, when fluoroscopy is performed for the purpose of guiding or localizing a needle or catheter tip for spinous or paraspinous injection procedures. Contrast may then be injected to determine whether the needle or catheter is in the correct place. When fluoroscopic guidance and localization for needle placement and injection is performed in conjunction with codes 64470-64476 and 64479-64484, code 77003 should be additionally reported. It would not be appropriate to report either code 76000 or 77002 in this circumstance. *To further clarify, code 77003 is intended to be reported per spinal region (not per level).* 
Since codes 62263, 62264, and 0027T include fluoroscopic guidance and localization, code 77003 is not reported in addition to these percutaneous or endoscopic lysis of epidural adhesion procedures.

CPT Assistant © Copyright 1990–2008 American Medical Association. All Rights Reserved 


Karen Maloney, CPC
Data Quality Specialist


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