Hi Heather,
The following is the rest of my response but there is a message length limit and had to split into 2 messages:
Caudal epidural injections are performed via the sacral hiatus. Here is a link for an illustration of the sacral anatomy: http://anatomy.med.umich.edu/atlas/back_bone4.html
The sacrococcygeal joint is located just below the sacral hiatus and the ganglion impar is located on the anterior side of the pelvis - anatomically anterior to the sacrococcygeal joint. Here is a link that shows this anatomy and needle placement in the sacrococcygeal joint to allow needle access for a ganglion impar injection: http://www.hpssandiego.com/ganglia%20impar.gif
I would not be comfortable with bypassing any bundling edits with the 59 modifier, particularly since the patient is covered by Medicare
The following is the rest of my response but there is a message length limit and had to split into 2 messages:
Caudal epidural injections are performed via the sacral hiatus. Here is a link for an illustration of the sacral anatomy: http://anatomy.med.umich.edu/atlas/back_bone4.html
The sacrococcygeal joint is located just below the sacral hiatus and the ganglion impar is located on the anterior side of the pelvis - anatomically anterior to the sacrococcygeal joint. Here is a link that shows this anatomy and needle placement in the sacrococcygeal joint to allow needle access for a ganglion impar injection: http://www.hpssandiego.com/ganglia%20impar.gif
I would not be comfortable with bypassing any bundling edits with the 59 modifier, particularly since the patient is covered by Medicare