# Coding 77003 with 62311 etc...



## amyschneberger (Jan 8, 2009)

We currently code the fluoro code 77003 with all of our epidurals (62310-62311), but I was reviewing the Ingenix CPT Expert and the note states under the descriptor for 77003 "Do not report with ...62310-62319".  Is fluoro considerded bundled into the epidural injection?  
I am confused because the definition of 77003 includes a parenthetical indicating it is used with epidural injections.  

When I review 62310, the notes state to "only report 77003 if a formal contrast study is performed".  What is considered a "formal contrast study"?

Thanks for the guidance...


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## RebeccaWoodward* (Jan 8, 2009)

I, too, had issues with CPT's statement.  I found this article and found it helpful.  As of yet, I haven't had any denials for 77003.  

Supporting Rationale:
1. CPT® provides for separate and distinct reporting
According to the introductory notes to the spinal injection section of the Current Procedural Terminology (CPT®) book, 
“Injection of contrast during fluoroscopic guidance and localization is an inclusive component of codes 62263, 62264, 62267, 62270-62273, 62280-62282, 62310-62319. Fluoroscopic guidance and localization is reported with code 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.” (Emphasis added.)
Although injection of contrast is an inclusive component of the spinal injections listed, fluoroscopic guidance is not. The CPT® text above clearly establishes that it is correct to report both the fluoroscopic guidance and the pain procedure when the procedure is done under fluoroscopy. Only the injection of contrast is bundled.

http://www.asahq.org/publicationsAndServices/standards/44.pdf


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## amyschneberger (Jan 8, 2009)

Thanks for the article, very helpful.


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## tauros0427 (Jan 8, 2009)

Never had a problem reporting 62311 with 77003...no rejections ever except at the beginning when the fluro code changed from 76005


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