# Billing 76942 with 62310-62319



## abrodskycpc (Aug 3, 2015)

Hi, 

We have a pain doctor who wants to bill 76942 with codes 62310-62319 instead of 77003. Has anyone ever come across this? 

I am not able to find any information on billing these codes together. 

Thanks in advance!


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## mitchellde (Aug 3, 2015)

Did the documentation specifically state ultrasound guidance?


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## abrodskycpc (Aug 3, 2015)

mitchellde said:


> Did the documentation specifically state ultrasound guidance?



I have not actually seen anything. I work for a billing service and one of our clients posed this question to us: 

"question for you. It seems as though ultrasound is coming more into favor for spinal injections. Obviously we will still plan to use fluoro, but I am not familiar with ultrasound for neuraxial injections. How is reimbursement generally for this?" 

I am not sure how to respond since I cannot actually find anything on this. I would appreciate any guidance or direction. 

Thanks,


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## dwaldman (Aug 3, 2015)

Below displays that Aetna, Cigna, United HealthCare state they do not cover epidural injections utilizing ultrasound guidance. I believe you will find this with Blue Cross Blue Shield also per the specific policies that you bill. Additionally, Medicare released in the 2015 final rule for physician fee schedule that image guidance is not separately reportable with epidural injections. 


"Aetna considers ultrasound guidance of epidural injections experimental and investigational because of insufficient evidence of its effectiveness."

http://www.aetna.com/cpb/medical/data/1_99/0016.html

"Epidural steroid injection with ultrasound guidance (0228T-0231T) for any indication "

https://cignaforhcp.cigna.com/publi...criteria_invasive_treatment_for_back_pain.pdf

"The use of ultrasound guidance for epidural steroid injection(s) and facet joint injection(s) is unproven and not medically necessary. There is insufficient clinical evidence regarding its safety and/or efficacy in published peer-reviewed medical literature. The available published evidence for ultrasound guidance for epidural and facet injections is limited to a small feasibility study and a cadaver study"

https://www.unitedhealthcareonline....roid_and_Facet_Injections_for_Spinal_Pain.pdf



"After considering comments received, we are finalizing CPT codes 62310, 62311, 62318, and 62319 as potentially misvalued, finalizing the proposed RVUs for these services, and prohibiting separate billing of image guidance in conjunction with these services."

https://www.federalregister.gov/art...he-physician-fee-schedule-clinical-laboratory


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## abrodskycpc (Aug 4, 2015)

dwaldman said:


> Below displays that Aetna, Cigna, United HealthCare state they do not cover epidural injections utilizing ultrasound guidance. I believe you will find this with Blue Cross Blue Shield also per the specific policies that you bill. Additionally, Medicare released in the 2015 final rule for physician fee schedule that image guidance is not separately reportable with epidural injections.
> 
> 
> "Aetna considers ultrasound guidance of epidural injections experimental and investigational because of insufficient evidence of its effectiveness."
> ...





Thank you thank you thank you!! Great info, I really appreciate it dwaldman!


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