Neurology & Pain Management Coding Alert

Question: My neurologist performed an epidurogram diagnostic study in conjunction with a fluoroscopically guided lumbar epidural injection. He obtained hard copy images of the epidurogram in multiple planes and prepared a formal radiologic report of his interpretation. I believe I can only report 72275 for this case. Is that correct?

Florida Subscriber

Answer: Yes, you may report 72275 (Epidurography,radiological supervision and interpretation) if the physician performs the separate diagnostic study, including the permanent radiologic images of the epidural space, and documents the diagnostic interpretation in a written report.

CPT states that 72275 includes 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, or sacroiliac joint], including neurolytic agent destruction), so you would not report both codes together for the same service.

Remember: There is a possibility of reporting both codes, but only if your neurologist performed fluoroscopy in one spinal region and epidurography in a totally separate spinal region, such as a cervical fluoroscopy and lumbar epidurography.

Tip: Correct Coding Initiative (CCI) edits bundle 72275 into the epidural injections codes. You may override the edit with a modifier if your documentation supports the separate nature and medical necessity of 72275.