# coding for pain specialist



## brinktwins (Apr 23, 2014)

I work for a Pain Specialist and they bill out CPT code 77003 along with CPT code 64483 & 64484.  When I look up CPT code 77003 way down in the description in green writing it says do not report 77003 along with certain CPT codes and 64483 & 64484 are in that list.  Why is that?  Right above this statement there is a description of transforaminal epidural needle placement & injection, see 64479-64484.



Please help give me some advice on how I should handle coding these claims.



Thank you very much for your help


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## mhstrauss (Apr 23, 2014)

brinktwins said:


> I work for a Pain Specialist and they bill out CPT code 77003 along with CPT code 64483 & 64484.  When I look up CPT code 77003 way down in the description in green writing it says do not report 77003 along with certain CPT codes and 64483 & 64484 are in that list.  Why is that?  Right above this statement there is a description of transforaminal epidural needle placement & injection, see 64479-64484.
> 
> 
> 
> ...



The code descriptions of 64479-64484 includes "with fluoro or CT needle guidance", which means the RVU/reimbursement for guidance is included in the primary procedure code.  The notation you see beneath 77003 directs you to check the primary codes, instead of using fluoro separately.  A few years ago, these injection codes did not include guidance, but since it is used the majority of the time these are performed, they revised the code set to include the guidance.  Same thing for the facet joint injections (64633-64636).  If any of these procedures are performed under CT or fluoro guidance, the guidance should not be coded/billed separately.

Hope this helps!


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## Melissa Harris CPC (Apr 23, 2014)

62310 and 62311 I believe are the only procedures you can bill the fluoro with.  I do know that Workers Comp is giving a hard time with these two codes.



Melissa Harris, CPC
The Albany and Saratoga Centers of Pain Management


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