vmounce
Guru
I HAVE A CLAIM THAT KEEPS DENYING FOR NON COVERED SERVICES BECAUSE THIS IS NOT DEEMED A MEDICAL NECESSITY BY THE PAYER.
CAN ANYONE HELP ME WITH THIS? I USED 64475 RT & 64476 RT WITH DIAGNOSIS 716.98 AND 724.2. HERE IS THE OP NOTE:
PREOPERATIVE DIAGNOSES:
1. Degenerative lumbar scoliosis with right concavity.
2. Status post right total knee replacement January 2008.
3. Chronic low back pain.
PROCEDURE: Facet joint injections.
ANESTHESIA: Local.
INDICATIONS: This lady had a facet block with good relief in the past. She also had a lumbar epidural steroid injection with no relief. She is here today to have facet blocks after clinical exam and palpation. She complains mainly of pain at the level of L2-L3 on the right side and also at the level of L4-L5 on the right side. Those areas being in the concavity of her degenerative lumbar scoliosis and given her problems because of the hyperpressure and her overweight situation.
OPERATIVE PROCEDURE: After prepping and draping of the patient's back, I used the C-arm and I located the facet joint at L2-L3 and I placed my spinal needle in the facet joint. I injected a solution of 2 cc of Depo-Medrol mixed with 3 cc of normal saline in and around the facet joint. Then I moved to L4-L5 on the right side and again I placed my needle under C-arm guidance in the facet joint of L4-L5 on the right and I injected also a solution of Depo-Medrol 2 cc mixed with 3 cc of normal saline. She tolerated the procedure well. I will see her back in the office in two months.
CAN ANYONE HELP ME WITH THIS? I USED 64475 RT & 64476 RT WITH DIAGNOSIS 716.98 AND 724.2. HERE IS THE OP NOTE:
PREOPERATIVE DIAGNOSES:
1. Degenerative lumbar scoliosis with right concavity.
2. Status post right total knee replacement January 2008.
3. Chronic low back pain.
PROCEDURE: Facet joint injections.
ANESTHESIA: Local.
INDICATIONS: This lady had a facet block with good relief in the past. She also had a lumbar epidural steroid injection with no relief. She is here today to have facet blocks after clinical exam and palpation. She complains mainly of pain at the level of L2-L3 on the right side and also at the level of L4-L5 on the right side. Those areas being in the concavity of her degenerative lumbar scoliosis and given her problems because of the hyperpressure and her overweight situation.
OPERATIVE PROCEDURE: After prepping and draping of the patient's back, I used the C-arm and I located the facet joint at L2-L3 and I placed my spinal needle in the facet joint. I injected a solution of 2 cc of Depo-Medrol mixed with 3 cc of normal saline in and around the facet joint. Then I moved to L4-L5 on the right side and again I placed my needle under C-arm guidance in the facet joint of L4-L5 on the right and I injected also a solution of Depo-Medrol 2 cc mixed with 3 cc of normal saline. She tolerated the procedure well. I will see her back in the office in two months.
