CodingMom2
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I want to know if I can bill the 62290, 72295 and J3301- Discogram with the injection 64999 (Intradiscal Injection )?
PMR Intradiscal Injection (1 Level)
Diagnosis:
Discogenic Low Back Pain
Disc Degeneration
Procedure:
Discogram at L2-L3
L2-L3 Intradiscal Steroid Injection
Fluoroscopic Guidance
____
The risks, benefits, and potential complications of the procedure, as well as alternative options, were discussed with the patient, and the patient gave consent to continue with the procedure.
Details of Procedure:
The patient was placed on the fluoroscopy table in the prone position using a pillow under the pelvis for positioning. The skin overlying the lumbosacral spine was prepped with Chloraprep and draped in the usual sterile fashion. The L2-L3 spinal interspace was identified by fluoroscopy. The C-arm was then placed in sufficient tilt to align the endplates. Next the C-arm was placed in left obliquity so that the lateral aspect of the superior articular nearly bisected the interspace. A 27-gauge, 1 1/2-inch needle was then used to locally anesthetize the skin and subcutaneous tissues with 1% lidocaine. A 25g x 4 11/16” spinal needle with a curved tip was inserted in line with the beam and advanced to contact the superior articular process. The needle was then redirected and advanced into the disc. The needle was advanced through the anulus and to the mid-portion of the disc on AP viewing. A lateral fluoroscopic view confirmed needle placement in the middle of the disc.
I then attached a 6-inch, low volume extension tube to the needle and injected Omnipaque 350 mixed with 7.5mg/ml of clindamycin which was used as a contrast agent. Injection of contrast revealed a severely degenerated disc. Once intradiscal placement was confirmed, I injected a solution containing equal parts of 40mg/ml Triamcinolone and 1% lidocaine. Approximately 2cc of the solution was injected. The needle was withdrawn, and a sterile dressing was applied to the site.
Complications:
None. The patient remained conversant throughout the procedure. The patient went to the recovery room in good condition.
I want to know if I can bill the 62290, 72295 and J3301- Discogram with the injection 64999 (Intradiscal Injection )?
PMR Intradiscal Injection (1 Level)
Diagnosis:
Discogenic Low Back Pain
Disc Degeneration
Procedure:
Discogram at L2-L3
L2-L3 Intradiscal Steroid Injection
Fluoroscopic Guidance
____
The risks, benefits, and potential complications of the procedure, as well as alternative options, were discussed with the patient, and the patient gave consent to continue with the procedure.
Details of Procedure:
The patient was placed on the fluoroscopy table in the prone position using a pillow under the pelvis for positioning. The skin overlying the lumbosacral spine was prepped with Chloraprep and draped in the usual sterile fashion. The L2-L3 spinal interspace was identified by fluoroscopy. The C-arm was then placed in sufficient tilt to align the endplates. Next the C-arm was placed in left obliquity so that the lateral aspect of the superior articular nearly bisected the interspace. A 27-gauge, 1 1/2-inch needle was then used to locally anesthetize the skin and subcutaneous tissues with 1% lidocaine. A 25g x 4 11/16” spinal needle with a curved tip was inserted in line with the beam and advanced to contact the superior articular process. The needle was then redirected and advanced into the disc. The needle was advanced through the anulus and to the mid-portion of the disc on AP viewing. A lateral fluoroscopic view confirmed needle placement in the middle of the disc.
I then attached a 6-inch, low volume extension tube to the needle and injected Omnipaque 350 mixed with 7.5mg/ml of clindamycin which was used as a contrast agent. Injection of contrast revealed a severely degenerated disc. Once intradiscal placement was confirmed, I injected a solution containing equal parts of 40mg/ml Triamcinolone and 1% lidocaine. Approximately 2cc of the solution was injected. The needle was withdrawn, and a sterile dressing was applied to the site.
Complications:
None. The patient remained conversant throughout the procedure. The patient went to the recovery room in good condition.