# fluroscopic w/c-arm guidance



## msalvatore (Feb 26, 2013)

PLEASE HELP!!!  My doctor is doing lumbar epidurals under fluroscopic and using c-arm guidance. Can I bill for the c-arm seperate? If so what would be the CPT code. This is new for me and I can not seem to find the answer I need.


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## aaron.lucas (Feb 26, 2013)

I think you might be misinterpreting what is there.  In my experience, "c-arm" and "flouroscopic" are the same thing, both referring to the fluoroscopic guidance used for the injection, so no you wouldn't separately for that, per se.  you would just bill for the fluoroscopy, assuming it's not included in whatever the procedure is that's being done.  hope that helps!


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## kvangoor (Feb 27, 2013)

When my provider uses the c arm in a procedure I use code 77002


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## aaron.lucas (Feb 27, 2013)

The use of 77002/77003 should be based on where the injection is being done.  If it's a spinal injection, 77003 should be used.  If it's a joint injection or an injection in a location other than the spine, then 77002 would be appropriate.  Choosing fluoro codes based on the equipment used would be inappropriate, it should be based on location and type of procedure.


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## MikeVee (Sep 24, 2015)

*pain mgmt*

It seems that code 64479 has a higher reimbursemnt rate and the description also includes guidance for the injections. Would this be the appropriate code to use for nerve blocking with C arm?


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## marvelh (Oct 1, 2015)

What code is reported would depend upon the type of injection and anatomically where the injection was performed.  Many of the spinal injection procedures include the image guidance and as such the fluoroscopy would not be separately billable.

64479 is specifically for cervical or thoracic transforaminal epidural injections aka selective nerve root blocks.  It would not be appropriate to report this code for other nerve blocks.  This code descriptor is one of them that requires image guidance, i.e. the fluoroscopy or CT can not be separately billed.


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