2025 CPT code 77003
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Radiologic Guidance Radiology Feed
Fluoroscopic guidance for needle or catheter placement in the spine or paraspinous area for diagnostic or therapeutic injections (epidural or subarachnoid).
Modifiers may be applicable depending on the circumstances of the service.For example, modifier 26 (professional component) may be used if only the professional component of the service was provided, and modifier TC (technical component) may be used under specific circumstances when billing only for the technical component of the procedure.
Medical necessity for code 77003 is established when fluoroscopic guidance is deemed necessary for accurate placement of the needle or catheter to minimize risks and ensure effective treatment or diagnosis. This may be due to the complexity of the anatomy, the proximity to critical structures, or the need for precise targeting.
The physician is responsible for preparing the patient, positioning them under the fluoroscope, inserting and maneuvering the needle or catheter under fluoroscopic guidance, administering contrast media, confirming the correct location, and delivering the diagnostic or therapeutic agent. Post-procedure care and monitoring are also the responsibility of the physician.
In simple words: This code describes a procedure where a doctor uses real-time X-ray imaging (fluoroscopy) to guide a needle or thin tube into the spine or nearby area.This helps them accurately place medication or take samples for testing to diagnose or treat a problem.
This CPT code, 77003, represents fluoroscopic guidance and localization of a needle or catheter tip within the spine or adjacent paraspinous region.The procedure involves using fluoroscopy to guide the placement of the needle or catheter for diagnostic or therapeutic injections into the epidural or subarachnoid space. This is an add-on code and must be reported in addition to a code for the primary procedure.The procedure is used to accurately target the injection site, minimizing risks and ensuring effective treatment or diagnostic sampling.
Example 1: A patient presents with chronic low back pain.The physician orders a fluoroscopically guided epidural steroid injection to alleviate pain. Code 77003 would be reported in addition to the code for the epidural injection., A patient experiences numbness and tingling in their legs, indicative of a possible spinal stenosis. A myelogram with contrast is planned.Code 77003 would be added to the code reflecting the myelogram., A patient requires a therapeutic injection of a neurolytic agent into the facet joint of the spine for pain management.Code 77003 is used in addition to the code representing the neurolytic injection.
* Detailed history and physical examination documenting the indication for the procedure.* Imaging studies (e.g., X-rays, MRI) justifying the need for fluoroscopic guidance.* Operative report specifying the approach, location, and confirmation of needle/catheter placement.* Documentation of the type and amount of contrast and therapeutic agent administered.* Post-procedure assessment and any complications.
** Accurate coding requires careful review of the procedure performed and the documentation to ensure compliance with NCCI edits and CPT guidelines.Improper coding may lead to claim denials or payment adjustments.
- Revenue Code: I4B
- Payment Status: Active
- Modifier TC rule: Modifier TC is not typically reported with code 77003, however, in limited situations depending on the context of the procedure, it could be applied.
- Specialties:Anesthesiology, Pain Management, Interventional Radiology, Neurosurgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)