Wiki Fluoroscopically guided lumbar epidural injections

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Lori22

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I am new to orthopedic coding & have a stack of LESI's to code. My doc generally does these in the outpatient setting. My question is, do I need to code the fluro with a 26 modifier in addition to the injection, or is this included in the cost of the injection?
 
It depends on the type of epidural. Based on the fact that you say LESI, I'm going to assume they are Interlaminar Epidurals (62310/62311), in which case the fluoroscopic guidance is not included for the physician, and you should bill 77003-26 along with your injection code. If however the doctor is doing a transforaminal epidural (64480-64485), the fluoro is included as of 1/1/2011. Hope this helps! :)

Just as a side note in case you are curious, fluoro would be included for the facility that the injection is done in (usually ASC), as the guidelines state "Injection of contrast during fluoroscopic guidance and localization is included in...62310-62319"
 
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