How To Use CPT Code 77002

CPT 77002 describes the use of fluoroscopic guidance for needle placement during procedures such as biopsy, aspiration, injection, or localization of a device. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 77002?

CPT 77002 involves the use of fluoroscopic guidance to assist in the placement of a needle for various procedures, including biopsy, aspiration, injection, or localization of a device. This code is used when the provider uses live X-ray images displayed on a monitor to guide the placement of the needle. It is important to note that CPT 77002 should not be reported if the primary procedure code already includes fluoroscopic guidance.

2. Official 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).’ This code should be used in conjunction with specific primary procedure codes listed in the notes section.

3. Procedure

1. When performing a procedure that requires needle placement, the provider prepares the patient and positions them under the fluoroscope.
2. The provider then uses fluoroscopic guidance to visualize the target area and determine the appropriate needle placement site.
3. Using the fluoroscope as a guide, the provider inserts the needle slowly and carefully into the desired region, advancing it to the designated location inside the body.
4. Once the needle is in the correct position, the provider may inject contrast material to confirm the proper needle placement.
5. After confirming the needle placement, the provider may proceed with diagnostic or therapeutic procedures, such as taking tissue samples, withdrawing fluid, or administering treatments.

4. Qualifying circumstances

CPT 77002 is used when fluoroscopic guidance is necessary for needle placement during procedures such as biopsy, aspiration, injection, or localization of a device. This code should not be reported if the primary procedure code already includes fluoroscopic guidance. It is important to review the specific primary procedure codes listed in the notes section to determine if CPT 77002 should be reported in addition to the primary procedure.

5. When to use CPT code 77002

CPT code 77002 should be used when the provider utilizes fluoroscopic guidance to assist in the placement of a needle for procedures such as biopsy, aspiration, injection, or localization of a device. It is important to ensure that the primary procedure code does not already include fluoroscopic guidance, as CPT 77002 should only be reported in addition to the primary procedure.

6. Documentation requirements

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

• Reason for the procedure and the need for fluoroscopic guidance
• Details of the procedure performed, including the specific needle placement technique
• Date and time of the procedure
• Confirmation of proper needle placement, such as the use of contrast material
• Any additional diagnostic or therapeutic procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 77002, ensure that the primary procedure code does not already include fluoroscopic guidance. CPT 77002 should only be reported in addition to the primary procedure. It is important to review the specific primary procedure codes listed in the notes section to determine if CPT 77002 should be reported. Modifier 52 (Reduced services) may be appended to the code if the radiology service is supervised by one provider and interpreted by another. Modifier TC should be appended if reporting only the technical component of the radiology service. However, payer policies may exempt hospitals from appending modifier TC. Modifier 26 should be appended if reporting only the professional component of the radiology service.

8. Historical information

CPT 77002 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. A radiologist using fluoroscopic guidance to place a needle for a biopsy procedure in the lung.
2. An orthopedic surgeon utilizing fluoroscopic guidance to inject medication into a joint for pain management.
3. An interventional radiologist using fluoroscopic guidance to place a needle for a drainage procedure in the abdomen.
4. A urologist performing a needle localization procedure with the assistance of fluoroscopic guidance.
5. A gastroenterologist using fluoroscopic guidance to place a needle for a liver biopsy.
6. A pain management specialist utilizing fluoroscopic guidance to inject medication into the spine for pain relief.
7. A vascular surgeon using fluoroscopic guidance to place a needle for an angiography procedure.
8. An interventional cardiologist performing a pericardiocentesis procedure with the assistance of fluoroscopic guidance.
9. A neurosurgeon utilizing fluoroscopic guidance to place a needle for a myelogram procedure.
10. An interventional radiologist using fluoroscopic guidance to place a needle for a radiofrequency ablation procedure.