How To Use CPT Code 77002

CPT 77002 is a code used for fluoroscopic guidance for needle placement in various medical procedures. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77002 procedures.

1. What is CPT 77002?

CPT 77002 is a code used to describe the use of fluoroscopic guidance for needle placement during various medical procedures such as biopsy, aspiration, injection, or localization of a device. Fluoroscopy is a technique that uses X-ray imaging to visualize real-time images of the body’s internal structures, allowing the provider to accurately guide the needle to the desired location.

2. 77002 CPT code description

The official description of CPT code 77002 is: “Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)”.

3. Procedure

1. The patient is prepped and draped in the appropriate position (supine or prone) under the fluoroscope.
2. The provider places the tip of the needle or catheter at the introduction site.
3. Using fluoroscopic guidance, the needle is inserted and advanced slowly to the designated location inside the body.
4. Once the needle reaches the appropriate level, contrast material is injected at the site to confirm proper needle placement.
5. The provider may then perform diagnostic or therapeutic procedures via the needle or catheter, such as localizing a specific area of interest, taking tissue samples, or injecting a substance to treat a condition.

4. Qualifying circumstances

Patients who require needle placement for biopsy, aspiration, injection, or localization of a device in any area of the body, except for the spine, are eligible to receive CPT 77002 services. The provider must use fluoroscopic guidance to accurately place the needle in the desired location.

5. When to use CPT code 77002

CPT code 77002 should be used when the provider uses fluoroscopic guidance for needle placement in various medical procedures, such as biopsy, aspiration, injection, or localization of a device. It is important to note that this code should not be used for procedures that already include fluoroscopic guidance or for needle placement in the spine or paraspinous region, which requires CPT code 77003.

6. Documentation requirements

To support a claim for CPT 77002, the provider must document the following information:

• The medical necessity for using fluoroscopic guidance for needle placement.
• A detailed description of the procedure, including the patient’s position, needle insertion site, and the use of contrast material to confirm needle placement.
• Any diagnostic or therapeutic procedures performed via the needle or catheter.
• Any complications or adverse events that occurred during the procedure.

7. Billing guidelines

When billing for CPT 77002, it is important to follow these guidelines:

• Report CPT 77002 as an add-on code with an appropriate primary code.
• Do not report CPT 77002 for procedures that already include fluoroscopic guidance or for needle placement in the spine or paraspinous region (use CPT 77003 instead).
• Follow Medicare guidelines for reporting radiology services when one provider supervises the service and another provider interprets it.
• Append the appropriate modifiers (26, TC, or 52) to the radiology code as needed.

8. Historical information

CPT 77002 was added to the Current Procedural Terminology system on January 1, 2007. The code was changed on January 1, 2017, with the previous descriptor being “Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)”.

9. Similar codes to CPT 77002

Five similar codes to CPT 77002 and how they differentiate are:

• CPT 77001: This code is used for fluoroscopic guidance for central venous access device placement, replacement, or removal.
• CPT 77003: This code is used for fluoroscopic guidance for spine or paraspinous needle placement.
• CPT 77012: This code is used for computed tomography guidance for needle placement.
• CPT 77021: This code is used for magnetic resonance guidance for needle placement.
• CPT 76942: This code is used for ultrasonic guidance for needle placement.

10. Examples

Here are 10 detailed examples of CPT code 77002 procedures:

1. Fluoroscopic guidance for needle placement during a liver biopsy.
2. Fluoroscopic guidance for needle placement during a joint aspiration.
3. Fluoroscopic guidance for needle placement during a soft tissue injection.
4. Fluoroscopic guidance for needle placement during a bone marrow biopsy.
5. Fluoroscopic guidance for needle placement during a paracentesis procedure.
6. Fluoroscopic guidance for needle placement during a thoracentesis procedure.
7. Fluoroscopic guidance for needle placement during a cyst aspiration.
8. Fluoroscopic guidance for needle placement during a percutaneous nephrostomy.
9. Fluoroscopic guidance for needle placement during a percutaneous biliary drainage.
10. Fluoroscopic guidance for needle placement during a percutaneous abscess drainage.