Neurosurgery Coding Alert

Question: How  can  we  report  fluoroscopic  guidance  with  epidural  injections in 2017? What are the new codes we can anticipate? Are we going to use code 77003 going to use code for fluoroscopy?

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]) for fluoroscopy when reporting epidural injections in 2017.

Note the new injection codes for 2017: The following are the four new codes that will apply form Jan 1, 2017:

• 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]).

New codes are inclusive of fluoroscopy when applicable: The epidural injection codes 62321, 62323, 62325, and 62327 are inclusive of fluoroscopic services.