Neurology & Pain Management Coding Alert

Question: May I report multiple units of fluoroscopic guidance when administering facet blocks to more than one injection site?

Iowa Subscriber

Answer: You should report only a single unit of 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) regardless of the number of injection sites. The physician does not encounter significant additional work in using fluoroscopic guidance for more than one injection site.

You could possibly report 76005 more than once on the same date of service, but only for separate patient encounters, which is an unlikely scenario.

Remember to append modifier -26 (Professional component) to 76005 for fluoroscopic guidance provided in a facility setting or using equipment not belonging to the administering physician.

-- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.