Radiology Coding Alert

Question: Our physician uses fluoroscopy and C-arm guidance for joint injections. How can we report the C-arm guidance?

Wisconsin Subscriber

Answer: The C-arm or “equipment” implies the technical component of the imaging guidance. You do not report it separately. You can report for the services of your physician depending upon the place of service. When your physician performs the injection in his office, the technical component is included in the global billing. This means that you would bill the appropriate radiology code without any modifier. If however your physician performs the procedure in a facility, he only bills for the professional component and indicates as such with modifier 26 (Professional component) appended to the radiology code.

Examples of radiology codes that might be applicable include 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural or subarachnoid]) for a spinal injection or 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) for a joint injection or an injection in a location other than the spine.