Radiology Coding Alert

Radiology coders hailed the addition of a new spinal fluoroscopy code in 2000 as adding much-needed specificity and increasing revenue. The new 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) allows the physician to bill for fluoroscopy associated with diagnostic or therapeutic injection procedures when a specific radiological supervision and interpretation (RS&I) code for the service is not available, says April Brazinsky, CCS, coding specialist for the Community Hospital of the Monterey Peninsula in California. In the past, coders were forced to assign the more general code, 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) or 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]). However, 76005 may be a pitfall for some radiology coders, she notes. Some interpreted 76005 as an add-on code, to be assigned in conjunction with 72275 or other specific spinal RS&I codes. This is not correct. Code 76005 is considered inclusive to 72275, and both cannot be assigned when epidurography is performed. Similarly, it cannot be assigned in addition to diagnostic myelography codes 72240, 72255, 72265 and 72270 or diskography codes 72285 or 72295. Instead, it will be reported for the RS&I services provided in conjunction with spinal and/or axial skeletal injection procedures when more specific RS&I codes are not available.