Wiki Coding both X-rays and Fluoroscopy for Surgeries?

[abazcoder]

Just wondering if other Surgery coders are billing for BOTH Fluoroscopy done during surgery (76000) as well as for X-rays taken at the time of the surgery (ex: 2 views of hip 73502). I've checked in Codify, and there are no bundling issues but to me, it seems it would be excessive billing, am I wrong? From my experience most insurance don't even want to pay for the Fluro during surgeries. Any thoughts?

 

[amyjph]

There are multiple references to 76000 in the NCCI manual. Also, it has separate procedure designation per CPT meaning they are generally bundled. “Separate Procedure” Coding
Like, you said, you're probably not going to get paid.
A couple NCCI snips from the musculoskeletal chapter:
16. Fluoroscopy (CPT code 76000) is an integral component of arthroscopic procedures, when performed. CPT code 76000 shall not be reported separately with an arthroscopic procedure. (CPT code 76001 was deleted January 1, 2019.)
6. Fluoroscopy reported as CPT code 76000 shall not be reported with spinal procedures, unless there is a specific “CPT Manual” instruction indicating that it is separately reportable. For some spinal procedures, there are specific radiologic guidance codes to report in lieu of these fluoroscopy codes. For other spinal procedures, fluoroscopy is used in lieu of a more traditional intraoperative radiologic examination which is included in the operative procedure. For other spinal procedure codes, fluoroscopy is integral to the procedure. (CPT code 76001 was deleted January 1, 2019.)

And one from the radiology chapter: 8. Fluoroscopy reported as CPT code 76000 is integral to many procedures including, but not limited, to most spinal, endoscopic, and injection procedures and shall not be reported separately. For some of these procedures, there are separate fluoroscopic guidance codes which may be reported separately. (CPT code 76001 was deleted January 1, 2019.)

Regarding the X-Rays, is the surgeon dictating a separate radiology report, or are they quick shots taken during the case for positioning, etc? If there is no separate report you can't bill the professional component. You would have to check with the payer, bundling, etc. to see if the specific X-Rays would be inclusive or not.

Intraoperative X-rays : Reader Question

Question: How do I bill for intraoperative x-rays?New Jersey Subscriber Answer: Intraoperative x-rays are those taken during surgery and read by the physician during the surgical session. Since an x-ray technician is present in the operating room to take the x-rays, the physician can bill for...

www.aapc.com