codedog
True Blue
I work at an ASC , doc office books it as 27093 ,while I insist its 20610. IF i AM wrong then ,then I will man up and admit I am wrong , but if not what simple words can I explain to doc office that they are coding it wrong
here is operative report
POSTOPERATIVE DIAGNOSIS: Hip degenerative joint disease.
OPERATIONS: 1. Left intraarticular hip joint injection and aspiration. 2. Fluoroscopic needle guidance.
ANESTHESIA: 2% lidocaine 5 cc and sodium bicarbonate 8.4% 5 cc; monitored anesthesia care.
BLOOD LOSS: None.
FLUIDS GIVEN: 200 cc lactated Ringer's solution.
URINE OUTPUT: None.
INJECTATE MIXTURE: Preservative-free bupivacaine 0.5% 4 mL and Depo-Medrol 40 mg 1 mL.
PROCEDURE IN DETAIL:
Informed consent was obtained. Operative site was marked in the holding area. The patient was then taken to the procedure room and placed in a supine position on the table. Skin was prepped with ChloraPrep solution and draped in a sterile fashion. A time-out was performed.
Using fluoroscopy, the left hip was examined. Skin wheal was raised. Subcutaneous tissue was anesthetized with 2% lidocaine mixture. Using an anterolateral approach, 22 gauge 5-inch spinal needle was directed with intermittent fluoroscopic guidance into the joint capsule. Aspiration was significant for 6 cc of straw-colored fluid. The aspirate was placed in a sterile container and sent to Pathology for routine cytology.
3 cc of Isovue M200 contrast was then injected during the live fluoroscopy. Arthrogram confirmed correct needle placement. There was no vascular uptake noted. After negative aspiration, the injectate mixture was instilled through the needle. The needle was then removed from the skin.
Band-Aid was placed over the skin entry site. The patient was transferred to the recovery area, monitored for 30 minutes, then discharged after a normal neurologic exam. Postprocedure and discharge instructions were given to the patient. There were no apparent complications. The patient tolerated the procedure well.
PAIN BEFORE THE PROCEDURE: 9/10.
PAIN AFTER THE PROCEDURE: 0/10.
DISPOSITION: Discharged to home in stable condition. The patient is to return to the clinic in two weeks.
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here is operative report
POSTOPERATIVE DIAGNOSIS: Hip degenerative joint disease.
OPERATIONS: 1. Left intraarticular hip joint injection and aspiration. 2. Fluoroscopic needle guidance.
ANESTHESIA: 2% lidocaine 5 cc and sodium bicarbonate 8.4% 5 cc; monitored anesthesia care.
BLOOD LOSS: None.
FLUIDS GIVEN: 200 cc lactated Ringer's solution.
URINE OUTPUT: None.
INJECTATE MIXTURE: Preservative-free bupivacaine 0.5% 4 mL and Depo-Medrol 40 mg 1 mL.
PROCEDURE IN DETAIL:
Informed consent was obtained. Operative site was marked in the holding area. The patient was then taken to the procedure room and placed in a supine position on the table. Skin was prepped with ChloraPrep solution and draped in a sterile fashion. A time-out was performed.
Using fluoroscopy, the left hip was examined. Skin wheal was raised. Subcutaneous tissue was anesthetized with 2% lidocaine mixture. Using an anterolateral approach, 22 gauge 5-inch spinal needle was directed with intermittent fluoroscopic guidance into the joint capsule. Aspiration was significant for 6 cc of straw-colored fluid. The aspirate was placed in a sterile container and sent to Pathology for routine cytology.
3 cc of Isovue M200 contrast was then injected during the live fluoroscopy. Arthrogram confirmed correct needle placement. There was no vascular uptake noted. After negative aspiration, the injectate mixture was instilled through the needle. The needle was then removed from the skin.
Band-Aid was placed over the skin entry site. The patient was transferred to the recovery area, monitored for 30 minutes, then discharged after a normal neurologic exam. Postprocedure and discharge instructions were given to the patient. There were no apparent complications. The patient tolerated the procedure well.
PAIN BEFORE THE PROCEDURE: 9/10.
PAIN AFTER THE PROCEDURE: 0/10.
DISPOSITION: Discharged to home in stable condition. The patient is to return to the clinic in two weeks.
_____________________________________