Wiki FLUoROSCOPY FOR FRACTURE REDUCTION

[hlmcintyre]

Need your help please in billing fluroscopy assistance for a closed reduction of a distal radius fracture. Do you bill the wrist code 73100 with a 26 or do you bill fluoro 76000-26. The physician did a closed reduction in the operating room and did fluorscopy to check position of the reduction. We have a copy of the films that were done.

Thank you

 

[cbeuerlein]

I use fluoroscopic 76000-26. Fluoroscopy is a continuous x-ray like a movie and x-ray are still shots. X-rays can be taken with the fluoroscopy.

 

[PLAIDMAN]

Need your help please in billing fluroscopy assistance for a closed reduction of a distal radius fracture. Do you bill the wrist code 73100 with a 26 or do you bill fluoro 76000-26. The physician did a closed reduction in the operating room and did fluorscopy to check position of the reduction. We have a copy of the films that were done.

Thank you

AAOS states in the global surgery package "intraprocedure photo(s) and/or video recording, excluding ionizing radiation" are included in major (90day) surgery. The 76000 code is "separate procedure" code which "usually" means it has already been designated as an integral component of a surgery and should not be billed.

I know the NCCI edits for medicare also include these 2 codes together. It is my understanding medicare does not pay fluoro codes for "spot shots" it is not the same as an x-ray (hence the different codes)

I do believe AAOS says you can bill for an x-ray to confirm reduction, but I would not use an x-ray code for fluoro.

I guess I am kind of surprised people are not getting the 76000 denied when billed with other procedures.

 

[OmkarT]

CPT 76000 denied

AAOS states in the global surgery package "intraprocedure photo(s) and/or video recording, excluding ionizing radiation" are included in major (90day) surgery. The 76000 code is "separate procedure" code which "usually" means it has already been designated as an integral component of a surgery and should not be billed.

I know the NCCI edits for medicare also include these 2 codes together. It is my understanding medicare does not pay fluoro codes for "spot shots" it is not the same as an x-ray (hence the different codes)

I do believe AAOS says you can bill for an x-ray to confirm reduction, but I would not use an x-ray code for fluoro.

I guess I am kind of surprised people are not getting the 76000 denied when billed with other procedures.

I agree that CPT 76000 is an integral part of many surgical Px. Per NCCI edits CHAPIV indicates "If fluoroscopy is performed during an endoscopic procedure, it is integral to the procedure. This principle applies to all endoscopic procedures including, but not limited to, laparoscopy, hysteroscopy, thoracoscopy, arthroscopy, esophagoscopy, colonoscopy, other GI endoscopy, laryngoscopy, bronchoscopy, and cystourethroscopy, some spinal procedures."