Neurosurgery Coding Alert

Question: When our surgeon performs spinal fusions, he often dictates the use of fluoroscopic guidance (and sometimes biplane fluoroscopic guidance) for accurate positioning of instrumentation. After researching the CPT book, I didn't see anything specific to fluoroscopic guidance for this purpose. Is 76000 the most correct code? California Subscriber Answer: Although you have found the most correct code (76000, Fluoroscopy [separate procedure], up to 1 hour physician time, other than 71203 or 71034 [e.g., cardiac fluoroscopy]), you should not report this along with the screw placement. The Correct Coding Initiative (CCI) bundles the fluoroscopic or plain radiographic imaging for screw placement into the instrumentation codes (+22840-22855). You-ll find that CCI bundles intraoperative imaging required for placement of spinal instrumentation into the instrumentation codes. Therefore, you should not separately report it.