Anesthesia Coding Alert

Question: How can we report fluoroscopic guidance with epidural injections in 2017? I recently included 77003 on the claim and received a denial. Can you explain this?

Florida Subscriber

Answer: You will no longer use the code 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid] [List separately in addition to code for primary procedure]) for fluoroscopy when reporting epidural injections in 2017.

Here's why: CPT^® 2017 introduced several new codes for injections with a date of service of Jan. 1, 2017, or later. The epidural injection codes within this group (62321, 62323, 62325, and 62327) include fluoroscopy, so you no longer report these procedures with 77003.

As a refresher, the new injection codes for 2017 are:

• 62320 (Injection[s], of diagnostic or therapeutic substance[s] [e.g., anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance) and 62321 (... with imaging guidance [i.e., fluoroscopy or CT])
• 62322 (.... interlaminar epidural or subarachnoid, lumbar or sacral [caudal]; without imaging guidance) and 62323 (... with imaging guidance [i.e., fluoroscopy or CT])
• 62324 (Injection[s], including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance[s] [e.g., anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance) and 62325 (... with imaging guidance [i.e., fluoroscopy or CT])
• 62326 (...... interlaminar epidural or subarachnoid, lumbar or sacral [caudal];  without imaging guidance) and 62327 (... with imaging guidance [i.e., fluoroscopy or CT]).