Radiology Coding Alert

Question: My radiologist performs epidural steroid injections. Would you explain how to decide between 76005 and 72275 when reporting this procedure?


New Mexico Subscriber

Answer: Great question because you have to choose between them - insurers won't pay for both.

Your first option is 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). Use this code for fluoroscopically guided needle placement and certain paraspinal diagnostic and therapeutic injections, including steroid injections. A small amount of contrast will generally be used to verify needle placement.

Snag: Under NCCI edits, you can't report 76005 if you report 72275 (Epidurography, radiological supervision and interpretation).

Report 72275 as the S&I code when documentation shows the physician injected contrast into the epidural space under direct fluoroscopy for a diagnostic study. The report might indicate that he studied the flow of contrast in the space around the nerves to help him diagnose compressive lesions, narrowing and swelling around the nerve or nerve roots, or intervertebral disk herniations.

Remember: You may only report 72275 if the physician performs an epidurogram including a permanent radiologic image of the epidural space, with interpretation and written report.