# 77002 and 77003



## TYSON1234

Good afternoon, I just have a general question. I started working for a Dr in Pain Management. There was an update in 2017 for 77002 and 77003 ( used as an add on code). Where I can I find the list of primary codes, besides the CPT manual??? This Dr. is really cheap and he will not listen to me. So, I need to show him proof of these changes.

Thanks for any help.


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## LisaAlonso23

If you're referring to CPT codes that now include those services, you will need to show him the description of the codes that now include 77002 and/or 77003.  The bundling information should be under the code(s).

Look at the 2018 CPT manual, page 412, code 64455 as an example. In the parenthetical information below the code, it specifically states fluoroscopy is inclusive (bundled) into codes 64479-64484.

Also, under those codes (page 473) there is parenthetical information that specifies which codes you may and may not report 77002/77003 with. 

I hope this helps.


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## TYSON1234

Thank you for the information, but I didn't know if there is a website that lists the codes I could bill. Like I said, he is cheap and he doesn't want to spend the $$$$ for the manual because he only uses a few of the codes.


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## dwaldman

Here is the codes, you should just order the book and paid for it yourself if the provider will not cover it. i would order the AMA CPT Professional Edition. If you discuss coding with the provider, you can incorporate that resource in the discussion such as the CPT manual you purchased and he will realize it as a standard necessity in the future once he sees how vital those parenthetical notes are from the AMA. 
_________
Use 77003 in conjunction with 61050, 61055, 62267, 62270, 62272, 62273, 62280, 62281, 62284, 64510, 64517, 64520, 64610

Do not report 77003 in conjunction with 62320, 62321, 62323, 62324, 62325, 62326, 62367

______________
Use 77002 in conjunction with 10022, 10160, 20206, 20220, 20225, 20520, 20525, 20526, 20550, 20551, 20552, 20553, 20555, 20600, 20605, 20610, 20612, 20615, 21116, 21550, 23350, 24220, 25726,27093,27095, 27370,27648, 32400,32405,32553,36002,38220, 38221, 38505,38784,41019, 42400, 42405,4700,47001,48102,49180,49411,50200,50390,51100,51101,51102,55700,55876,60100,62268,62269,64505,64508,64600,64605


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## brogdonlawn

*62370 with 77002*

My doctor refilled a pump and was unable to see where to refill it at and was having a lot of difficulty so instead of going to the hospital and doing through outpatient services he used our fluoroscope in our office to be able to fill it.  We received a denial for the 77002 because it did not have an add on code.  How can we show it was medically necessary to use the fluoro for this.  We have probably used it 5 times total in the past 3 years with hundreds of refills.


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## devinmajor14

Report 77002 in conjunction with 10022, 10160, 20206, 20220, 20225, 20520, 20525-20526, 20550-20553, 20555, 20600, 20605, 20610, 20612, 20615, 21116, 21550, 23350, 24220, 25246, 27093, 27095, 27370, 27648, 32400, 32405, 32553, 36002, 38220-38221, 38505, 38794, 41019, 42400, 42405, 47000-47001, 48102, 49180, 49411, 50200, 50390, 51100-51102, 55700, 55876, 60100, 62268-62269, 64505, 64508, 64600, and 64605

Report 77003 in conjunction with 61050, 61055, 62267, 62270, 62272-62273, 62280-62282, 62284, 64510, 64517, 64520, 64610, and 96450


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## brogdonlawn

*77002/77003*

My pain pump refill is a 62370.  It is not in the code set that allows fluoro but it is medically necessary to use the fluoro on this particular patient to refill the pump. How do we get paid for using the fluoroscope.


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## dykline

_brogdonlawn
77002/77003

My pain pump refill is a 62370. It is not in the code set that allows fluoro but it is medically necessary to use the fluoro on this particular patient to refill the pump. How do we get paid for using the fluoroscope._

I didn't know whether you got an answer somewhere else. If you closely read the description for 77002, it includes the localization of a device. Just because it isn't on the specified list does not exclude its use, so long as "fluoroscopic guidance" is not included in the primary procedure descriptor. I don't know if we actually got paid for it; I have coded 62370 with 77002 when the provider was unable to locate the port on a morbidly obese patient. I'm a coder, not a biller. Trust me, our billing department would have let me know if it was denied. 77002 is an add-on code; meaning it's added to the primary procedure--62370. The description for 77002 also tells you to report it "separately in addition to code for primary procedure." You do have to retain an image and a radiology report in the patient's record. I work in a Critical Access Hospital and there are different guidelines for some things just as there are state-to-state. We also have access to our State Revenue Manual which can be very helpful. And a check of Medicare's NCCI list always helps.
Go to page 33 at this link. If it won't open, copy and paste in your browser. I'm sorry if it doesn't work.
https://www.cms.gov/Medicare/Coding...Downloads/2017-NCCI-Correspondence-Manual.pdf 
You also can look up CPT codes online, just make sure you use a reputable site. The AMA even has a free search; you have to create a log-in and it is limited to 5 searches per day which isn't near enough for me. I'm a book person and have bought some my employer wouldn't provide--never a waste of money. Best of luck! 

Radiology: Radiologic Guidance

CPT Assistant, February 2015, Volume 25, Issue 2, page 10 

Question: What is the appropriate way to report pericardiocentesis if performed under fluoroscopic guidance? 

Answer:

When a needle is placed with fluoroscopic guidance during a pericardiocentesis procedure, it may be appropriate to report code 77002, Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, _localization device_), for the radiological supervision and interpretation part of the procedure. The surgical part of the procedure may also be reported with code 33010, Pericardiocentesis; initial, or code 33011, Pericardiocentesis; subsequent. [emphasis added]


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## Urvishah

dykline said:


> _brogdonlawn
> 77002/77003
> 
> My pain pump refill is a 62370. It is not in the code set that allows fluoro but it is medically necessary to use the fluoro on this particular patient to refill the pump. How do we get paid for using the fluoroscope._
> 
> 
> 
> I have same question , Medicare denied all 62370 with 77002, It is medical neccassary and provider mentioned that he needs fluro for the needle placement! Now any input that how can we get paid?


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