I know NOTHING of spinal coding other than the fact that it's difficult! 
I don't want to screw this up, and I'm not even sure what procedure code to start with! Can someone help me code this please? TIA!
PROCEDURE: Posterior thoracic laminectomy for insertion of spinal cord stimulator; left-sided implantable pulse generator. Intraoperative complex programming with neurostimulator.
INDICATION OF PROCEDURE: This patient presented to our office with severe abdominal pain, chronic in nature, and responsive to percutaneous nerve stimulation with St. Jude. The patient was therefore scheduled for a permanent implantation of the same.
DISCUSSION OF PROCEDURE: After obtaining informed consent, the patient underwent induction of satisfactory general anesthesia. Upon placement of _______, prepped and draped in a sterile fashion. Posterior thoracic midline and left side of buttock was prepped and draped and 0.5% Marcaine with epinephrine was used to infiltrate the skin over the pre-mark area where fluoroscopically the patient?s T7 and T8 spinous processes were identified. A midline incision was made over the thoracic spine. Subperiosteal dissection was performed to explore the laminae of T7 and T8 and _______ was brought in place. Initially, a laminotomy was performed over the T7 and T8 regions to identify the epidural space, large enough to accommodate the St. Jude tripolar stimulator. This was inserted with ease without any undue ventral pressure and was put in the midline behind the T6 and T7 vertebral body. However, upon comparing it with the trial data, it was found that the T7 vertebral body had been marked with taking into consideration the last transverse process which is large accounting that as a T12 rib. Therefore, decision was made to move the simulator to down one level and therefore a small laminotomy was performed at the lower level and sufficiently large epidural space was again created to accommodate the tripolar lead. The tripolar lead was introduced into the caudal space and then centered over the new T6-T7 disc space in the midline. This was correlated with the trial data and matched it one to one. This was anchored to the caudal disc with silk sutures and the back incision was created to accommodate St. Jude pulse generator. It was checked for hemostasis and a large passer was used to ______ the leads from the thoracic midline into the buttocks. They were cleaned and inserted into the St. Jude rechargeable pulse generator with the _______ lead into the bottom row, inserted and tightened with torque and a screwdriver. Wound was then irrigated. The battery was placed, checked for impedance, and found to be satisfactory. Wound was then re approximated with 3-0 Vicryl. The _____ was secured with a silk suture. Care was taken not to bring the suture near the leads. Intraoperative complex programming of the stimulator was found to be satisfactory
I don't want to screw this up, and I'm not even sure what procedure code to start with! Can someone help me code this please? TIA!PROCEDURE: Posterior thoracic laminectomy for insertion of spinal cord stimulator; left-sided implantable pulse generator. Intraoperative complex programming with neurostimulator.
INDICATION OF PROCEDURE: This patient presented to our office with severe abdominal pain, chronic in nature, and responsive to percutaneous nerve stimulation with St. Jude. The patient was therefore scheduled for a permanent implantation of the same.
DISCUSSION OF PROCEDURE: After obtaining informed consent, the patient underwent induction of satisfactory general anesthesia. Upon placement of _______, prepped and draped in a sterile fashion. Posterior thoracic midline and left side of buttock was prepped and draped and 0.5% Marcaine with epinephrine was used to infiltrate the skin over the pre-mark area where fluoroscopically the patient?s T7 and T8 spinous processes were identified. A midline incision was made over the thoracic spine. Subperiosteal dissection was performed to explore the laminae of T7 and T8 and _______ was brought in place. Initially, a laminotomy was performed over the T7 and T8 regions to identify the epidural space, large enough to accommodate the St. Jude tripolar stimulator. This was inserted with ease without any undue ventral pressure and was put in the midline behind the T6 and T7 vertebral body. However, upon comparing it with the trial data, it was found that the T7 vertebral body had been marked with taking into consideration the last transverse process which is large accounting that as a T12 rib. Therefore, decision was made to move the simulator to down one level and therefore a small laminotomy was performed at the lower level and sufficiently large epidural space was again created to accommodate the tripolar lead. The tripolar lead was introduced into the caudal space and then centered over the new T6-T7 disc space in the midline. This was correlated with the trial data and matched it one to one. This was anchored to the caudal disc with silk sutures and the back incision was created to accommodate St. Jude pulse generator. It was checked for hemostasis and a large passer was used to ______ the leads from the thoracic midline into the buttocks. They were cleaned and inserted into the St. Jude rechargeable pulse generator with the _______ lead into the bottom row, inserted and tightened with torque and a screwdriver. Wound was then irrigated. The battery was placed, checked for impedance, and found to be satisfactory. Wound was then re approximated with 3-0 Vicryl. The _____ was secured with a silk suture. Care was taken not to bring the suture near the leads. Intraoperative complex programming of the stimulator was found to be satisfactory