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Anesthesia Coding Alert

Reader Question:

Code Epidurography Instead of Fluoro -- Sometimes

Published on Thu Mar 11, 2004

Question: One of our physicians always uses fluoroscopic guidance to place the needle for an epidural injection. He then injects Omnipaque dye and wants to code the procedure as epidurography instead of fluoroscopy. He dictates brief notes about what the epidurography shows, but I'm not sure if this is enough to qualify as a formal radiologic report.

New Jersey Subscriber
 
Answer: Most carriers will reimburse this type of epidurography if the physician dictates it separately and if the procedure is medically necessary.

Report 72275 (Epidurography, radiological supervision and interpretation) and append modifier -59 (Distinct procedural service) because you performed the procedure in addition to the epidural injection. Code the epidural with 62310 (Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epiduro-graphy], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62311 (... lumbar, sacral [caudal]), depending on the injection site.
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