Wiki Fluoro with 64450

[celcano]

My physician bills 77003 with 64450. I checked the CCI edits and they bundle 77001 and 77002 into 64450. However, there is nothing on 77003. It seems strange to me that 77001/77002 would be bundled, but not 77003. Is that because 77003 was never meant to be used with 64450 or is it that 77003 is not bundled into 64450?

I also want to thank you all who take the time to respond to my questions. I an relative new to pain management. It seems the more I understand, the more questions I have. I appreciate your taking the time to help me.

 

[dwaldman]

NCCI is considering the majority of the time CPT 64450 is performed on anatomical location other than the spine. I believe this is being reported for lateral branch block of nerves innervating the SI Joint. The fact that they consider CPT 77002 bundled I would assume they believe fluoroscopic guidance is bundled with this code but you could write them to clarify if there is an exception for when CPT 64450 represent a procedure anatomically
located in the spine region.

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html

National Correct Coding Initiative
Correct Coding Solutions LLC
P.O. Box 907
Carmel, IN 46082-0907

Attention: Niles R. Rosen, M.D., Medical Director and Linda S. Dietz, RHIA, CCS, CCS-P, Coding Specialist

Fax #: 317-571-1745

 

[NIENAJADLY]

What nerve is the provider targeting? 64450 is for a peripheral nerve but 77003 is for a spinal/paraspinal procedure. 77002 seems more appropriate but is bundled with the code.