# 2017 Epidural Codes: w/or w/o Image Guidance



## dwaldman

Below in the Medicare Physician Proposed Rule for 2017, it appears there are going to be new epidural codes to differ from with image guidance (Fluoroscopy, CT) or without image guidance



Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017

https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-16097.pdf

Page 384

623X5 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without
imaging guidance



623X6 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging
guidance (ie, fluoroscopy or CT)



623X7 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without 
imaging guidance



623X8 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with 
imaging guidance (ie, fluoroscopy or CT) 


623X9 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, cervical or thoracic; without imaging guidance



62X10 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, 
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, cervical or thoracic; with imaging 
guidance (ie, fluoroscopy or CT)



62X11 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, lumbar or sacral (caudal); without 
imaging guidance



62X12 Injection(s), including indwelling catheter placement, continuous infusion or intermittent 
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)


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## dwaldman

CPT code numbers now available for 2017 

62320 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without
imaging guidance



62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging
guidance (ie, fluoroscopy or CT)



62322 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without 
imaging guidance



62323 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, 
opioid, steroid, other solution), not including neurolytic substances, including needle or 
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with 
imaging guidance (ie, fluoroscopy or CT) 


62324 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, cervical or thoracic; without imaging guidance



62325 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, 
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, cervical or thoracic; with imaging 
guidance (ie, fluoroscopy or CT)



62326 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, lumbar or sacral (caudal); without 
imaging guidance



62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent 
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or 
subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)


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## Rbilling

I am just a little confused with cpt 77003. 
If we bill the new codes in 2017 - 623X6 & 623x8 which state with Flouro would we still need to bill the 77003 to report we did it or is 623X6 & 623X8 enough? 
Also is the x part of the new code or will it be replaced with a number.


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## KMCFADYEN

You will only bill/code the 623x6 & 623x8 alone.  
77003 is included per CPT book


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## enancy79

*Modifier 26 and New Spinal codes*

Is the professional service noted with modifer -26 also included in the new spinal codes.  Would 62323 and 77003-26 be billed together?


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## sherryk1968

No, you would only bill 62323 because it includes imaging guidance.




enancy79 said:


> Is the professional service noted with modifer -26 also included in the new spinal codes.  Would 62323 and 77003-26 be billed together?


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## SALLYCPR

*When Billing procedure code 62323 x 2 levels. 2 lines 62323- 2-50*

When Billing procedure code 62323 x 2 levels. 2 lines 62323- 2-50?


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## LisaAlonso23

SALLYCPR said:


> When Billing procedure code 62323 x 2 levels. 2 lines 62323- 2-50?



On page 401 of the CPT manual, it states that 62323 (there is a list of other codes too) is selected based on the region at which the needle or catheter entered the body.  It should only be reported once.


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