# 77003 Fluoro guidance



## SWheeldon (Mar 12, 2013)

Hi all!  I have a question about fluoro guidance and localization of needle or catheter tip for spine:  is it now inclusive to the lumbar puncture 62270?  It has come to my attention this month because an internal edit is denying 77003 with just about everything now!  The edit states a parenthetical in the CPT book:

  "Injection of contrast during fluoroscopic guidance and localization [77003] is included in 22526, 22527, 27096, 62263, 62264, 62267, 62270-62282, 62310-62319."

I think it's being misinterpreted to say the fluoro is included, instead of the injection of contrast is included.  If they read further down it lists the do not report codes with 77002 and 77003 as 22586, 27096, 64479-64484, 64490-64495, 64633-64636, 0195T, 0196T, 0309T.

So now when we code for a lumbar puncture of 62270 and 77003, the 77003 is hitting an edit.  But when I look it up in CCI, there is no edit.  Where can I get documentation to prove that 77003 is coded and billable with the 62270-62282 codes?

Any help is greatly appreciated!


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## chembree (Mar 15, 2013)

For certain spinal procedures, fluoroscopy is NOT considered inclusive of the procedure (eg, 62267, 62270-62282, 62310-62319) and is indeed separately reportable, when performed.

Injection of contrast during fluoroscopic guidance and localization is an inclusive component of 62263, 62264, 62267, 62270-62273, 62280-62282, 62310-62319. Fluoroscopic guidance and localization is reported with 77003, unless a formal contrast study (myelography, epidurography, or arthrography) is performed, in which case the use of fluoroscopy is included in the supervision and interpretation codes.

http://www.ama-assn.org/ama1/pub/upload/mm/362/errata-nov2010.pdf
This is an errata to a misprint to this very topic.


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