fradyk
New
Our office is performing SPG Block using SphenoCath. Is it appropriate to bill code 64505 for this service? Lidocaine is administered through the SphenoCath. I am running into conflicting information stating that if the SPG Block is not administered by actual injection you should not use code 64505 (injection, anesthetic agent; sphenopalatine ganglion) and should be reported as 64999 (unlisted procedure, nervous system). Here is an example of the procedure:
- Patient placed in supine position with gentle neck extension. Skin cleansed vigorously with alcohol wipes. Micro crystalline temperature reading sticker placed on both sides of face. Baseline cutaneous temperature readings recorded _____. Both nostrils visually examined for internal nasal anatomy, any evidence of recent epistaxis, purulent nasal drainage, visible abnormalities or obstruction and none noted. Lidocaine 2% jelly applied with cotton tipped applicator into each separate nostril and patient instructed to sniff to coat the passageways. Sphenocath attached to syringe containing 3cc of 2% lidocaine, and dipped in viscous lidocaine. Pressurized delivery of 1.5cc given in right nasal passageway over the middle turbinate into the speno-palatine fossa, and then procedure repeated in the left nasal passageway.
- 2 minutes post left sided procedure completion the change in microcrystalline temperature probe readings indicated a bilateral increase of at least 3 degrees Fahrenheit.
- Bilateral conjunctiva redness observed.
- Tearing occurred in the bilateral lateral canthus.
- Patient reported _______% reduction in pain symptoms.
Thanks,
Kerri Frady, CPC
- Patient placed in supine position with gentle neck extension. Skin cleansed vigorously with alcohol wipes. Micro crystalline temperature reading sticker placed on both sides of face. Baseline cutaneous temperature readings recorded _____. Both nostrils visually examined for internal nasal anatomy, any evidence of recent epistaxis, purulent nasal drainage, visible abnormalities or obstruction and none noted. Lidocaine 2% jelly applied with cotton tipped applicator into each separate nostril and patient instructed to sniff to coat the passageways. Sphenocath attached to syringe containing 3cc of 2% lidocaine, and dipped in viscous lidocaine. Pressurized delivery of 1.5cc given in right nasal passageway over the middle turbinate into the speno-palatine fossa, and then procedure repeated in the left nasal passageway.
- 2 minutes post left sided procedure completion the change in microcrystalline temperature probe readings indicated a bilateral increase of at least 3 degrees Fahrenheit.
- Bilateral conjunctiva redness observed.
- Tearing occurred in the bilateral lateral canthus.
- Patient reported _______% reduction in pain symptoms.
Thanks,
Kerri Frady, CPC