Anesthesia Coding Alert

Version 7.3 of the Correct Coding Initiative deleted a comprehensive edit that was introduced three months ago. Version 7.2 edited 76005 (fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) with 27096 (injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid).
 
"The edit was an error, which version 7.3 has corrected," says Patricia Bukauskas, CPC, a pain-management coding and reimbursement specialist in Alliquippa, Pa. The removal of the edit, Bukauskas says, puts the CCI back in agreement with CPT, which states, "For radiological supervision and interpretation, use 73542. If formal arthrography is not performed, recorded, and a formal radiologic report is not issued, use 76005 for fluoroscopic guidance for sacroiliac joint injections."
 
"The edit was probably introduced because it was felt that the physician could not tell if he or she was in the sacroiliac joint (to make the injection) without fluoroscopic guidance, and therefore, fluoroscopy was perceived as incidental to the injection," she says. Some physicians now use a "walkdown" technique that allows them to enter the sacroiliac joint space without fluoroscopy.