# Seperate procedure



## LaVoncye (Jul 30, 2013)

I am coding a selective transforaminal epidural steroid injection L3, L4, L5 under fluoroscopy and Lumbar Epidurogram.

I know that the Fluro is included in the 64483 my question is am I able to code the epidurogram separately, I'm confused with the wording as to if I can bill it separately. When I read the report it stated the collective epidurogram results are shown below.


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## dwaldman (Jul 30, 2013)

I would just bill for the epidural procedure if I was in your situation. We don't bill for 72275 is the stance we take at the practice I work with.


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## LeslieJ (Jul 31, 2013)

*epidurogram*

The sad thing is that clinical-ese doesn't always equate to billing-ese.  

A true epidurogram is a diagnostic radiologic procedure used to review the spinal structures. It requires a separate report in order for it to be billed, as well as meeting a few certain other criteria.

Physicians routinely call the image that they get from a fluoroscope "epidurogram" but this kind of language can and does confuse the coder.  The image itself is from the fluoro - but isn't the diagnostic procedure.

I wrote an article on it here:  http://www.beckersasc.com/asc-coding-billing-and-collections/coders-guide-to-epidurogram-cpt-72275.html  , gave references to why I wrote what I did, and included a little bit of a cheat-sheet to help you figure out when 72275 is billable vs. when it's just an image.

Hope this helps!

L J


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