Radiology Coding Alert
Look Into Epidurogram Reason
Question: We received a denial for a claim for the following report. Which CPT codes should we use? A 22-gauge spinal needle was advanced into the epidural space at L4-L5 and L5-S1 on the left from a transforaminal approach under fluoroscopic guidance. Epidural placement was confirmed with loss of resistance technique and epidurogram with 3cc of Omnipaque 300 was performed. Spot images were obtained. Following lumbar epidurography and confirming placement of the needle within the epidural space a mixture of 80 mg of Depo-Medrol and 4 cc of 0.25 percent Marcaine was injected at each level. Texas Subscriber Answer: The radiologist documents transforaminal injections and fluoroscopic guidance. Injections: For the transforaminal anesthetic and steroid injections at the left L4-L5 and L5-S1 epidural spaces, you should report 64483 (Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level) for the first lumbar injection and +64484 (... lumbar or sacral, each additional level [List separately in addition to code for primary procedure]) for the additional level injection. Guidance: You may report the fluoroscopic guidance separately with 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). You should report 77003 only once. Careful: The radiologist documents the term "epidurogram," but you should not report 72275 (Epidurography, radiological supervision and interpretation). The service 72275 describes is a diagnostic tool. You should not use 72275 to describe radiological guidance to confirm needle placement.
Radiology Coding Alert
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Match CSF Study to Proper MR Code
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Look Into Epidurogram Reason
Question: We received a denial for a claim for the following report. Which CPT codes [...] - Reader Questions:
Consider Coding UAE Microspheres
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