# Fluoro with 64450



## celcano (May 7, 2015)

My physician bills 77003 with 64450.  I checked the CCI edits and they bundle 77001 and 77002 into 64450.  However, there is nothing on 77003.  It seems strange to me that 77001/77002 would be bundled, but not 77003.  Is that because 77003 was never meant to be used with 64450 or is it that 77003 is not bundled into 64450?

I also want to thank you all who take the time to respond to my questions.  I an relative new to pain management.  It seems the more I understand, the more questions I have.  I appreciate your taking the time to help me.


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## dwaldman (May 11, 2015)

NCCI is considering the majority of the time CPT 64450 is performed on anatomical location other than the spine. I believe this is being reported for lateral branch block of nerves innervating the SI Joint. The fact that they consider CPT 77002 bundled I would assume they believe fluoroscopic guidance is bundled with  this code but you could write them to clarify if there is an exception for when CPT 64450 represent a procedure anatomically 
located in the spine region.

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html

National Correct Coding Initiative
 Correct Coding Solutions LLC
 P.O. Box 907
 Carmel, IN 46082-0907

Attention: Niles R. Rosen, M.D., Medical Director and Linda S. Dietz, RHIA, CCS, CCS-P, Coding Specialist

Fax #: 317-571-1745


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## NIENAJADLY (Nov 10, 2015)

What nerve is the provider targeting?  64450 is for a peripheral nerve but 77003 is for a spinal/paraspinal procedure.  77002 seems more appropriate but is bundled with the code.


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