Eli's Rehab Report

Question: Our doctors just started performing epidurographies (72275). I told them that an epidurography would include a fluoroscopy and that they shouldn't separately report it unless they have documentation. Is that appropriate?


Texas Subscriber


Answer: You may not report CPT 72275 (Epidurography, radiological supervision and interpretation) for fluoroscopic guidance and verification of proper needle placement. You should report this service as 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).

An epidurogram is a diagnostic procedure: It includes a permanent radiologic image of the epidural space, with interpretation and written report. A physician injects a contrast into the epidural space under direct fluoroscopy.

CPT directs that you should report an epidurogram in a formal radiologic report. The epidurogram procedure report must document the area injected, the substance(s) injected, and the dosage of the substance(s).

Typically, the report describes the flow of the contrast into the epidural space, any blockages to flow found, and the flow along the nerve roots. The interpreting physician must sign the interpretation and written report. A report that states, "Epidurogram completed without difficulty" does not meet the requirements as a 72275.

For example, if you have a report that states, "A small amount of contrast injected, insufficient to image the epidural space," you should report 76005, not 72275.

Note: CPT includes 76005 in the work represented by 72275. Also, the National Correct Coding Initiative (NCCI) bundled these codes to reflect this. You can override this edit if your documentation supports a separate and distinct service, such as a different anatomic region.

(Editor's note: You can find more information regarding this topic at the American Society of Interventional Pain Physicians Web site: www.asipp.org/.)