Basics of Fluoroscopy CPT code 76000, 76001, 77001, 77002, 77003
Fluoroscopy is used mostly as a guidance in coding interventional radiology reports. I always used to have little confusion while using fluoroscopy CPT codes along with surgery codes. Initially it is very difficult for a coder to read and code a medical report, but once you follow the ICD and CPT coding guidelines, you become perfect in coding a medical report.
Fluoroscopy CPT codes differ from procedure to procedure. For example, CPT code 77001 is used for vascular procedure while CPT code 77002 is used for non-vascular procedure like biopsy, injection etc. both are fluoroscopy codes. Also, CPT code 77003, one more fluroscopy code is used extensively only for spinal procedures.
Hence, if you are perfect in coding surgery report, you will know exactly which fluoroscopy CPT code should be used. I know, medical coders struggle a lot in coding surgery report, especially interventional radiology reports. For Clearing a Certification exam like CPC, coders must learn everything about theses codes. So, let us checkout the different fluoroscopy CPT codes 77001,77002,77003,76000 and 76001, used along with surgery CPT codes.
What is Fluoroscopy?
Fluoroscopy is a continuous x-ray beam that creates a sequence of images that are then transmitted to a monitor, which helps the provider to evaluate the structure(s) in question. Fluoroscopy may be performed to evaluate specific areas of the body, including the bones, muscles, and joints, as well as solid organs, such as the heart, lung, or kidneys. It is a radiologic imaging modality which can be performed independently or in combination with the diagnostic procedures. As we have different fluoroscopic guidance codes like 76000, 76001,77001, 77002 and 77003, we usually get confuse which one to use while coding medical reports.
It is important to become familiar with the use of the fluoroscopy codes 77001-77003. Fluoroscopic guidance can be performed as the sole imaging associated with a procedure (77001-77003) for which both the procedure and the fluoroscopic guidance are reported. Fluoroscopy may be performed in combination with other imaging during a procedure (eg, peripherally inserted central venous catheter using both ultrasound 76937 and fluoroscopic guidance 77001) for which the procedure and both imaging codes are reported. For certain procedures, fluoroscopy is considered inclusive of the procedure (eg, 22526, 22527, 62263, 62264, 62267, 62270-62282, 62310-62319) and not separately reportable. Fluoroscopic guidance is considered inclusive of certain organ or anatomic-specific radiological supervision and interpretation procedures 74320, 74355, 74445, 74470, 74475, 75809, 75810, 75885, 75887, 75980, 75982, 75989. Since fluoroscopic imaging requires personal supervision, if the physician is not present in the operating room during a procedure that uses fluoroscopy or fluoroscopic guidance, that physician should not submit a code for fluoroscopy. However, the appropriate radiographic code to report the anatomy evaluated should be submitted in the event that (a) the radiologist’s contract with the hospital requires that a radiologist issue a formal interpretation, or (b) the physician performing the study requests that a radiologist produce a formal report of the procedure from permanent images recorded.
When to use CPT code 76000 and 76001
Being myself a medical coder, I always have a doubt when to use CPT codes 76000 and 76001. But, later while coding some charts related to CPT codes 76000 and 76001, I concluded few important tips. CPT code 76000 is most of the times included in the radiology procedures codes. So, coders should check the CCI edit whether CPT code 76000 is inclusive or not with the primary radiology procedure. If the fluoroscopy procedure is performed separately or independently, we have to append 59 or X{EPSU} modifier to indicate that it is a distinct or independent service. Below is the code description of the CPT code 76000.
Code 76000, Fluoroscopy (separate procedure), up to one hour physician time,
You can see that the code description states that, the code should be assigned only when fluoroscopy is performed separately or independently
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