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When to code CPT code 77003 and When not

Basic about Cpt Code 77003

Guidance codes are important in Interventional radiology coding. Percutaneous surgery procedure is mostly depending upon guidance like ultrasound or fluoroscopic guidance. The imaging guidance CPT codes are different for vascular and non-vascular percutaneous procedures like CPT code 77003 is used for non-vascular exam like spinal procedure and 77001 for vascular procedure like central line placement. For ultrasound guidance also we have separate codes for vascular and non-vascular percutaneous procedure. Cpt Code 76937 is used for vascular procedure and 76942 cpt code is used for non-vascular procedure like biopsy. This differences between vascular and non-vascular procedures really helps in improving our skills in coding ICD and CPT codes. Let’s learn which are the CPT codes are used with CPT code 77003. This guidance is used with very less procedure codes but very important one. Cpt Code 77003 is used mainly in spinal injection procedures.

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When to code CPT code 77003 and When not

Revised CPT code 77003 in 2017

CPT code description of 77003 is being revised in 2017. The new description for this procedure codes is given below.

77003 – Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure) 

 The CPT code 77003 is  revised with the descriptors to include the parenthetical note (List separately in addition to code for primary procedure) and revises the global periods for both codes to reflect an add-on code; a global value ZZZ. Additional modifications were made to the instructions and vignettes for each code in the CPT manual

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Procedures use CPT code 77003

The steroid injection procedure of spine use fluoroscopic guidance CPT Code 77003. The different cpt codes used for steroid epidural injection are 62310 (deleted in 2017), 62311 (deleted in 2017) and 27096. The steroid injection is injected into the epidural or subarachnoid space of the spine. The CPT code 77003 is now included with procedure code 62310 and 62311. Cpt Code 77003 is included with 27096 also hence we are not allowed to code it separately.

There are separate codes for injection in facet joints or Z joints. The facet or Z joint is the bony surfaces between vertebrae that articulate with each other. The CPT codes used for facet joint injection, ranges from 64490-64495. Copt Code 77003 should not be report with CPT codes 64490-64495. A facet joint injection code includes fluoroscopic guidance CPT Code 77003.

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New CPT codes for 62310 and 62311 in 2017

For coding 62310, we have to report new CPT code 62310 and for coding 62311 exam, we have report cpt code 62322 from 2017. Below is the code description for the new codes.

62320 (Injection[s], of diagnostic or therapeutic substance[s] [eg, anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance). 

62322 (Injection[s], of diagnostic or therapeutic substance[s] [eg, anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral [caudal]; without imaging guidance).

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Lumber puncture with CPT code 77003

Lumbar puncture procedures are performed under fluoroscopic guidance. Cpt Code 77003 is coded along with Lumbar puncture CPT Code 62270. Even when therapeutic spinal puncture procedure use fluoroscopic guidance 77003. Don’t forget to code CPT code 77003 along with spinal puncture procedure since they don’t include any guidance codes.