Procedure Help


Toledo, Ohio
Best answers
So, one of my pain docs performed the following and I think I have the correct codes, just looking for a confirmation.....

Evacuation of seroma - 10140
Dye Study - 61070
Reprogramming & Electronic analysis of pain pump - 62368

This was performed w/Fluoro... There are no edits for CPT 77002 with any of these codes, but it seems like unless it's specially in the list of codes since this is an add-on code, it always gets denied.

Procedure report:
The lumbar spine interspace was localized with fluoroscopy. After the skin the was anesthetized with lidocaine 2% and bupivicaine 0.5% equal volumes, using a 25-gauge needle, a longitude incision was then made at skin using an 11-blade. Using a combination of sharp dissection/blunt dissection/electrocautery, the incision was taken through the subcutaneous tissue until the lumbar paraspinal fascia was identified. There was a gush of about 200 ml of clear fluid that came out. There are no signs of infection in the whole area. I could not identify any area of leakage of CSF or any area of leakage from the catheter. We confirmed the patency of the catheter by accessing the catheter access port as follows:

The catheter access port was accessed using the kit provided by the manufacturer. Clear cerebrospinal fluid was then aspirated from the intrathecal catheter confirming that the catheter was patent. Approximately 3 ml was siphoned off. Using a 2-0 Tycron, I took a purse-string suture around the catheter entrance through the lumbar paraspinal fascia.

Positioning of the catheter was rechecked and confirmed with fluoroscopy. Wounds were copiously irrigated. Incisions were closed with 2-0 Vicryl in the subcutaneous layer, 3-0 Vicryl in the dermis, and 3-0 Novafil in the epidermis.

Electronic analysis of the pump was performed to ensure proper functioning. The pump was then programmed to deliver a bridge bolus of the medication to the tip of the catheter and then the pump was programmed to deliver the planned dose and was double checked by two personnel to minimize any errors. I increased the pump to 1.7 mg a day.