We are being denied payment from Medicare for all 64625. Is anyone else having this problem? Is there anything different we can do? Date of service is 5/26/20
Left lower back pain
Injection
Sacroiliac Joint: Sacroiliac Joint RF
Prior to Procedure
Prior to Procedure: Time out completed before, Informed consent obtained, Risks explained, Benefits explained
Patient Position
Patient Position: prone
Imaging Modality Used
Imaging Modality Used: Fluoroscopy
Fluroscopy View Used: AP view, lateral view, 10 degree cephalad view
Time exposed to radiology:
1 minute and 8 seconds
Level
Level: Left
Procedure
Level Place: Left, SA(Sacral Ala), S2, S1, Lateral Branches
Number of Injection Sites: 5
Needle Gauge, Length, Type
Needle Gauge: 20 Gauge
Needle Length: 100mm
Needle Used: Stryker Venom Needle
Testing
Motor Testing: Left, S2, S1, SA, 3.0 Volts
Extremity motor stimulation: No
Medications
Depomedrol Dose: 80 mg
Bupivacaine 0.25%ml each Level: 2 ml
Bupivicaine 0.25%ml total dose: 10 ml
Lesioning
RF Lesion at each level: 80 degrees Celsius for 90 seconds, radiofrequency ablation
CSF Present
CSF Present: Negative
Heme Present
Heme Present: No
Parasthesia
Paresthesia Present: No
Post-Procedure
Procedure done under: Local
Patient Physical Location: Pain Clinic
Complication: no complications
Left lower back pain
Injection
Sacroiliac Joint: Sacroiliac Joint RF
Prior to Procedure
Prior to Procedure: Time out completed before, Informed consent obtained, Risks explained, Benefits explained
Patient Position
Patient Position: prone
Imaging Modality Used
Imaging Modality Used: Fluoroscopy
Fluroscopy View Used: AP view, lateral view, 10 degree cephalad view
Time exposed to radiology:
1 minute and 8 seconds
Level
Level: Left
Procedure
Level Place: Left, SA(Sacral Ala), S2, S1, Lateral Branches
Number of Injection Sites: 5
Needle Gauge, Length, Type
Needle Gauge: 20 Gauge
Needle Length: 100mm
Needle Used: Stryker Venom Needle
Testing
Motor Testing: Left, S2, S1, SA, 3.0 Volts
Extremity motor stimulation: No
Medications
Depomedrol Dose: 80 mg
Bupivacaine 0.25%ml each Level: 2 ml
Bupivicaine 0.25%ml total dose: 10 ml
Lesioning
RF Lesion at each level: 80 degrees Celsius for 90 seconds, radiofrequency ablation
CSF Present
CSF Present: Negative
Heme Present
Heme Present: No
Parasthesia
Paresthesia Present: No
Post-Procedure
Procedure done under: Local
Patient Physical Location: Pain Clinic
Complication: no complications
