2025 CPT code 77002
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Radiologic Guidance Radiology Feed
Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device).This code is reported in addition to the primary procedure code.
Modifiers 26 (professional component), 52 (reduced services), and TC (technical component) may be applicable depending on payer policies and the specifics of the service provided.
Medical necessity is established when there is a documented clinical indication for the procedure, such as a suspicious mass requiring biopsy, a joint effusion requiring aspiration, or a need for targeted medication injection.The use of fluoroscopic guidance should be justified by the complexity of the procedure and the need to ensure accurate needle placement.Documentation should support that the procedure was medically necessary and the fluoroscopic guidance was essential for its safe and accurate performance.
The physician is responsible for the proper preparation and draping of the patient, positioning under the fluoroscope, insertion of the needle under fluoroscopic guidance, injection of contrast material to confirm placement, and performance of the subsequent diagnostic or therapeutic procedure.
In simple words: This code describes the use of live X-ray imaging (fluoroscopy) to guide a doctor in placing a needle into the body for a procedure like a biopsy, taking a fluid sample, or injecting medicine. This imaging helps ensure the needle is in the right place.The cost of this imaging is added to the cost of the main procedure.
This CPT code, 77002, represents fluoroscopic guidance for needle placement during procedures such as biopsy, aspiration, injection, or localization of a device.It involves using fluoroscopy to visualize body structures and guide the insertion of a needle for diagnostic or therapeutic purposes. The procedure excludes needle placement in the spine or paraspinous region.This code is always reported as an add-on code, appended to the primary procedure code, and is included within the global period of the primary procedure.It should not be reported with arthrography radiological supervision and interpretation codes.
Example 1: A patient presents with a suspicious lung nodule detected on a CT scan.The physician uses fluoroscopic guidance to perform a needle biopsy of the nodule.Code 77002 is reported in addition to the biopsy code., A patient complains of persistent knee pain. The physician uses fluoroscopic guidance to perform a diagnostic aspiration of the knee joint to identify any underlying cause of the pain.Code 77002 is reported with the aspiration code., A patient requires injection of medication into a specific area of a deep-seated lesion. The physician uses fluoroscopic guidance to accurately place the needle and administer the medication. Code 77002 is reported in conjunction with the injection procedure.
Complete patient history and physical examination notes.Radiology reports including the indication for the procedure, imaging technique used, specific location of needle placement, confirmation of needle placement using contrast, and description of the procedure performed.Anesthesia record if applicable.Pathology report if a biopsy was performed.
** This code should only be reported when fluoroscopic guidance is used for needle placement outside the spine or paraspinous region.The use of fluoroscopy should be clearly documented in the medical record.This code is an add-on code and should always be reported with a primary procedure code.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- Global Days: This code is an add-on code and is included in the global period of the primary procedure.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be applicable if only the technical component of the fluoroscopic guidance service is reported.Payer policies may vary, and hospitals may be exempt from appending this modifier.
- Specialties:Radiology, Interventional Radiology, various surgical specialties
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center