Reader Question:
Yes, You Can Report 77003 With 62311
Published on Fri Oct 07, 2011
Question: Medicare denies our claim when we bill 62311, 77003, and 64483 together. The physician performs the separate injections on the same day and uses fluoroscopic guidance for the epidural. Medicare denies the CPT 77003 as bundled. We know it is bundled into 64483, but it's not bundled into 62311. How should we handle this situation? Massachusetts Subscriber Answer: Assuming the provider performs the epidurals at separate levels, your claim should include three lines: 64483 (Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level) with modifier 59 (Distinct procedural service) appended 62311 (Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opiod, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]) 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection [...]