Neurosurgery Coding Alert

Question: Can I report fluoroscopy in conjunction with pain management blocks? If so, what code should I use for the fluoroscopy?

Kansas Subscriber

Answer: Yes, you can report fluoroscopy with the pain management block. Your code selection will depend on the type of injection the physician administered.

If he performed a spine or paraspinous injection procedure, report 77003 (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).

Examples of spine or paraspinous injections include a cervical epidural injection (62310, 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, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or a lumbar facet joint injection (64475, Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level).

You must append modifier 26 (Professional component) to the fluoroscopy code unless your physician owns/leases the equipment and employs any technical staff. The documentation should briefly state that the physician used fluoroscopy.