2025 CPT code 76000
(Active) Effective Date: N/A Revision Date: N/A Radiology - Diagnostic Radiology Feed
Fluoroscopy, up to 1 hour physician or other qualified healthcare professional time (separate procedure).
Modifiers are applicable. Modifier 26 (Professional Component) may be used if only the professional component is being billed. Modifier 59 (Distinct Procedural Service) may be appended when 76000 is performed in addition to another procedure on the same anatomic area, but is separate and distinct from that procedure.
Medical necessity must be established for the separate fluoroscopy. It must be necessary for diagnostic or therapeutic purposes that are not adequately addressed by other imaging or procedures. The documentation should clearly demonstrate the clinical rationale for the separate fluoroscopy.
In simple words: This is a special type of x-ray, called a fluoroscopy, that creates moving images of the inside of your body. The doctor watches these live images on a screen for up to an hour to help diagnose a problem or guide a treatment. It is only billed when it's a separate procedure, not part of another procedure done at the same time.
This code represents a separate fluoroscopy procedure performed by a physician or other qualified healthcare professional, lasting up to one hour.Fluoroscopy uses a continuous X-ray beam to create real-time images of internal structures, often used to guide procedures or assess function. This code is not to be reported when fluoroscopy is an integral part of another procedure or when supervision and interpretation codes already encompass the fluoroscopy performed.
Example 1: A patient presents with a prior chest x-ray suggesting a lung density. Fluoroscopy is used to confirm the density's location and whether it's within the lung tissue, rib, or chest wall., A patient with a prior joint x-ray showing a calcification near the joint undergoes fluoroscopy with the joint in various positions (flexed, extended, rotated) to determine if the calcification is loose within the joint., A radiologist assists a surgeon in removing a radiopaque foreign body under fluoroscopic guidance, and there's no separate S&I code for this guidance.
Documentation should support the medical necessity of the separate fluoroscopy and clearly indicate the duration, anatomic location, and the specific clinical question being addressed. If performed with another procedure, documentation must justify it as a distinct and separate service.
- Modifier TC rule: Modifier TC (Technical Component) is not applicable to 76000, as it represents physician/qualified healthcare professional time and not the technical component of the procedure.
- Specialties:Radiology, Interventional Radiology, and other specialties using fluoroscopic guidance.
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, and other facilities where fluoroscopy can be performed.