IT pump drained for MRI and then refilled on same DOS

alannae

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Patient is scheduled for MRI and needs to have their pump drained before the MRI. The patient returns after the MRI to have their pump refilled.

Partial Note:

Pt in for pump drain prior to MRI today. He reports that he is still having significant pain. He states the pain control is up and down and there are times throughout the day that he hurts. His knees are still hurting, but he wants to get control of his neck pain before proceeding with the knees.

Pump analyzed and reprogrammed with drainage of medication.
dose set to 0.00 for MRI

Later the same day:
Patient had MRI and returned for the remainder of the refill.
Pump reprogrammed and refilled with:
Concentration: hydromorphone 3 mg/ml x20 cc
dose: constant flow at 1.6 mg/day
alarm date: September 19

Knee MRI reveals bone on bone and meniscal injury. He will follow up with orthopedics, but injections have not been helpful. He needs either surgery or a knee rhizotomy. Will schedule the genicular block to see if rhizotomy would be of benefit

Schedule right knee genicular block
f/u after procedure



Based on the note, I would code 62368 and 62370 (plus the OV). Any opinions about whether billing both 62368 and 62370 are justified? I'm leaning on 'yes' since the patient had 2 visits on the same day and they were distinctly separate services.

Any thoughts or experience on how to best bill this?

Thanks!
 
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