Michele1229
Networker
Hello everyone -
I am hoping to get some help on this op report regarding the CPT codes.
Patient placed in prone position and under sterile prep and drape of the lumbar and thoracic region, local was given at the T12-L1 interspace. A #14 gauge Tuohy needle was placed midline into the epidural space via loss of resistance with air. A St. Jude lead was placed through the needle adn advanced to the bottom of T7 just right of midline. A second needle was placed at the T11-T12 level after local to the skin. The second lead was placed t approx T8. The patient was allowed to awaken from anesthesia. Each needle was stimulated and found to have abdominal stimulation only. The leads were repositioned and we could not obtain leg or low back stimulation. The needles were removed. The same procedure was trialed once again at one level lower, after local to the skin and IV sedation. Both leads were placed in the midline area and once again the only stimulation felt was in the abdomen. Decision made to do peripheral leads on the lumbar area to see if we could cover lumbar pain. Local was given in each right and left flank, and the needle was placed from cephaled to cauded on the right and left side of the lumbar spine approx 10cm from midline on each lead. The stimulaor leads were placed. The needle and stylets were removed intact. Patient awakened and excellent stimulation coverage obtained.
Provider billed 63650 x 1 and 63650 x 1 but I didn't think that was right.
Thanks!!
I am hoping to get some help on this op report regarding the CPT codes.
Patient placed in prone position and under sterile prep and drape of the lumbar and thoracic region, local was given at the T12-L1 interspace. A #14 gauge Tuohy needle was placed midline into the epidural space via loss of resistance with air. A St. Jude lead was placed through the needle adn advanced to the bottom of T7 just right of midline. A second needle was placed at the T11-T12 level after local to the skin. The second lead was placed t approx T8. The patient was allowed to awaken from anesthesia. Each needle was stimulated and found to have abdominal stimulation only. The leads were repositioned and we could not obtain leg or low back stimulation. The needles were removed. The same procedure was trialed once again at one level lower, after local to the skin and IV sedation. Both leads were placed in the midline area and once again the only stimulation felt was in the abdomen. Decision made to do peripheral leads on the lumbar area to see if we could cover lumbar pain. Local was given in each right and left flank, and the needle was placed from cephaled to cauded on the right and left side of the lumbar spine approx 10cm from midline on each lead. The stimulaor leads were placed. The needle and stylets were removed intact. Patient awakened and excellent stimulation coverage obtained.
Provider billed 63650 x 1 and 63650 x 1 but I didn't think that was right.
Thanks!!