Differential injection??

cbheusman

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Good evening! I was hoping for some help with the following operative report.

Post op dx: Left hip tendonitis

Indications:...At this time she is not having any real problems with instability, but more with clicking and pain in the hip. On examination, she has tenderness over the psoas and the rectus femoris area. She decided to proceed with the differential injection.

Procedure: Pt was brought back to operating room where IV sedation was ensued. She was prepped with Betadin, received the Ancef, and then two differential injections were given. The first inj was done in the iliopsoas. Omnipaque dye was used to ensure that there was streaking of the iliopsoas, and 10 cc of a combination of bupivacaine, lidocaine and 40 mg of Kenalog was injected into the iliopsoas tendon and sheath. The second inj was done in the anterior portion of the hip joint and capsule along the anterior labrum and the anterior capsular area. This was done on the rectus femoris confirmation by dye, and also injected with bupivacaine, lidocaine and Kenalog. At that time all instruments were removed. The pt awakes and the pain had been resolved and the hip felt quite good.

Any help would be greatly appreciated.
Cathy
 

eblanken

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You didn't state whether this was done in conjunction with radiological imaging but since the note mentions an injection of Omnipaque, a contrast agent, I am going to assume so. Take a look at 27093. Although 20610 would normally be used for the injection of the kenalog, lidocaine, & bupivacaine in this case it is bundled with 27093 per CCI. Hope this helps.
 
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