# Transforaminal with fluoroscopy



## louettayg (Jan 21, 2011)

I understand you won't be able to bill for the fluoroscopy service (77003) when you perform a transforaminal. Does this only apply to Medicare or for all carriers?


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## RebeccaWoodward* (Jan 21, 2011)

This is not carrier specific.  *CPT* included fluoro in the changes for 2011.  The description now includes fluoroscopy or CT.


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## brockorama01 (Jan 21, 2011)

Philosophical question:  Are they going to eventually bundle fluoro with all pain procedures eventually? 

Rant:  I completely disagree with the AMA's bundling of fluoro primarily due to the personal risk associated with fluoro.  Pain fluoro is the only radiological service where the physician stands next to the x-ray device.  While the physician is shielded with aprons, collars, glasses and even lead-lined latex gloves, the phsyician is still exposed radiation several thousand times a year.  Also the physician is personally manipulating and directing the equipment...Not sitting in a dark room hundreds of miles away reviewing films.

Thank you and good night

Brock Berta


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## dwaldman (Jan 22, 2011)

I was just looking at this week a Draft LCD from WPS Medicare J5 stating that 20610 is not appropriate to bill for an SI Joint block without fluoroscopic guidance. That imaging guidance for this block is "crucial" and that only 27096 77003 & G0260 would be payable. 
I don't think that it is so much as they are trying to bundled as the fact is that they are trying to require in the sense that if they follow the medical literature that the paying for procedures that can maxmize the best possible outcomes if they feel utlizing fluoro helps achieve that it becomes a standard of care and those providing  that level of  care are able use the codes that define that service as the total procedure and again is not considered an opitional  component but the only way you even get to report the code.


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