Epidurogram Medical Necessity

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CLINICAL GUIDELINES - eviCore

https://www.evicore.com/-/media/files/evicore/clinical-guidelines/solution/msk--advance/2021/cmm-404--epidurography_eff061521_pub022221.pdf

Clinical guidelines for medical necessity review of Comprehensive Musculoskeletal Management Services. ... Epidurography (CPT®72275) includes fluoroscopic guidance, epidurogram, documentation of images, and a formal written report. These should not …

Article - Billing and Coding: Epidural Steroid Injections …

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56681

The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed. The …

Epidurography and therapeutic epidural injections: …

https://pubmed.ncbi.nlm.nih.gov/10319985/

Epidurography in conjunction with epidural steroid injections provides for safe and accurate therapeutic injection and is associated with an exceedingly low frequency of untoward …

BCBSNJ Medical Policy for - (Radiology) Policy Number - 144

https://services3.horizon-bcbsnj.com/hcm/MedPol2.nsf/MedicalPolicies/HNBE-9Y7NKW

CMM-404.1: Definitions. Epidurography is radiography of the spine after a radiopaque medium has been injected into the epidural space. It is used as a diagnostic study to …

Use of Fluoroscopy for Interlaminar Lumbar Epidural …

https://aanos.org/wp-content/uploads/2014/02/Epidurogram.pdf

Symptomatic patients with lumbar radiculopathy who did not respond to medical treatment were included. Patients with a history of cauda equina syndrome requiring emergent …

Coder's Guide to Epidurogram (CPT 72275) - Becker's ASC

https://www.beckersasc.com/asc-coding-billing-and-collections/coders-guide-to-epidurogram-cpt-72275.html

Many of the requirements needed to code and bill for the epidurogram (CPT 72275) are found in the providing physician's decision-making processes, but are not documented …

Epidurography w/epidural injection | Medical Billing and …

https://www.aapc.com/discuss/threads/epidurography-w-epidural-injection.122166/

Based on the epidurographic findings, potential treatment options can be evaluated. Code 72275 differs from code 76005 in that it represents a formal recorded …

Medical Policy Epidural Steroid Injections for Neck …

https://www.bluecrossma.com/common/en_US/medical_policies/690%20Epidural%20Steroid%20Injections%20for%20Neck%20and%20Back%20Pain%20prn.pdf

The above medical necessity criteria MUST be met for the following codes to be covered for Commercial Members: Managed Care (HMO and POS), PPO, Indemnity, Medicare …

Epidural Steroid Injections for Spinal Pain – …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/epidural-steroid-injections-spinal-pain.pdf

For initial Injection, medical notes documenting the following, when applicable: Diagnosis History of the medical condition(s) requiring treatment or surgical intervention …

Percutaneous Decompression Laminotomy (CPT …

https://www.cms.gov/Medicare/Coverage/DeterminationProcess/Downloads/Kloth_comment_05012013.pdf

Medical versus surgical treatment for low back pain: evidence and clinical practice. Eff Clin Prac1999;2:218t. -227 • No pressure on spinal cord • Mobile/flexible • No symptoms (pain, …

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