Orthopedic Coding Alert
How to Tell When to Use 77002 and 76000
Question: In the reconstructive surgeon’s office “office where I work, I see”, I see the same two imaging codes over and over again when it comes to wrist reconstructions: 77002 and 76000. I need the code that helps guide the surgeon through a bilateral wrist procedure in real time. Any suggestions? Tennessee Subscriber Answer: The code you want is 76000 (Fluoroscopy [separate procedure], up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 [eg, cardiac fluoroscopy]) helps guide orthopedic surgeons through their procedures. This code is used in procedures that require real-time imaging. This only account for one wrist, however. To account for the bilateral procedure, you need to append modifier 50 (bilateral procedure). This will account for imaging on both wrists. Altogether, you should code 76000-50. You should avoid code 77002 (Fluoroscopic guidance for needle placement [eg, biopsy, aspiration, injection, localization device] [List separately in addition to code for primary procedure]). Some procedures require needles to help guide an orthopedic surgeon, but this code does not account for having the information relayed in real time.
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