# 64479-64484 changes for 2011



## Jasper74 (Jan 7, 2011)

I noticed these codes were revised for 2011 to include "imaging guidance (fluoroscopy or CT) and contrast injection." Does this mean that we do not have to code the 77003 for a facility anymore? I am thinking not... but want to double check. Thanks for any help you might be able to provide.


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## betty.harder (Jan 7, 2011)

redavis74 said:


> I noticed these codes were revised for 2011 to include "imaging guidance (fluoroscopy or CT) and contrast injection." Does this mean that we do not have to code the 77003 for a facility anymore? I am thinking not... but want to double check. Thanks for any help you might be able to provide.


According to ingenix on-line: As an "add-on" code, 64480 is not subject to multiple procedure rules. No reimbursement reduction or modifier 51 is applied. Add-on codes describe additional intraservice work associated with the primary procedure. They are performed by the same physician on the same date of service as the primary service/procedure, and must never be reported as a stand-alone code. Use 64480 in conjunction with 64479. These are unilateral procedures. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers. Modifier 50 identifies a procedure performed identically on the opposite side of the body (mirror image). Report fluoroscopic guidance separately; see 77003. For subarachnoid, subdural, epidural, or caudal injection, see 62310-62319.


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## anuja.devasthali (Jan 14, 2011)

*CPT 64483 with CPT 77003*

No ; I am not agree with Betty's opinion.

I think the revised description for CPT 64483 , 64484 , 64479, 64480 clearly includes Fluroscopic guidance  so one should not report CPT 77003 separately.

But I have another doubt that what about Epidural steroid injections ( Lumbar or cervical ) CPT 62310 & 62311 ? Do these codes include Fluroscopic guidance as well ?

Description for CPT 62310 & 62311 is not revised but revised description of CPT 77003 states " Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, subarachnoid, or sacroiliac joint), including neurolytic agent destruction "


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## Anna Weaver (Jan 14, 2011)

My thinking is that the 64479-64480, 64483-64484 all include the fluoro (77003) as of Jan 1. The 62310, 62311 do not include this. My Doc ALWAYS uses fluoro when doing the transforaminals and facets. He does not always use fluoro to do the epidurals. I think they are trying to combine (like they did last year with the facets) those procedures where it is common practice to use fluoro and make it all inclusive. If they find that most everyone uses fluoro to do the epidurals, I think you will see those becoming combined in future. Just my opinion.


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