MsLady
New
Having an issue with coding implantation of trial supraorbital neurostimulator. I've been coming up with 64553 (x2) with 63650 (x2)
Here's the operative report:
Complex region pain syndrome type I, unspecified (head and neck)
1. Implantation of neurostimulator electrode array right supraorbital nerve-trial
2. Implantation of neurostimulator electrode array left supraorbital nerve-trial
3. Implantation of neurostimulator electrode array right upper posterior cervical nerve roots-trial
4. Implantation of neurostimulator electrode array left upper posterior cervical nerve roots-trial
IV prophylaxis was administered 30 minutes prior. She was taken to the operating room and allowed to position herself comfortably supine. Sterile prep and drape and local infiltration across the forehead with 10cc of Xylocaine 1% with 1:200,00 epinephrine.
Small incision were made over each temple approximately 2mm in size using a #15 scalpel blade. Though each incision was advanced a curved 4-inch 14-gauge tuohy needle. The needle was advanced in the subcutaneous tissue plane over the known anatomic distribution of the supraorbital nerves bilaterally. Through each needle was advanced a 60cm wide space quadripolar lead array. Needles were withdrawn. Imaging was utilized to assure that the active portion of each lead lay over the known anatomic distribution of the supraorbital nerves bilaterally.
We then sutured the leads in place using interrupted 2-0 silk, placed an occlusive bandage containing the leads across the patient's forehead and assisted the patient in turning prone onto the operating room table. Again sterile prep and drape, local infiltration with an additional 10cc of the above local anesthetic cocktail was performed. A small midline 2mm incision was made through which was advanced additional curved 4inch 14-gauge tuohy needles on right and one left in the subcutaneous tissue plane over the known anatomic distribution of upper posterior cervical nerve roots bilaterally. We then advanced through each needle and additional 60 cm wide space quadripolar lead array. The needles were removed again imaging was used to confirm optimal positioning of each lead. We then sutured the leads in place to the skin surface using interrupted 2-0 silk, placed an occlusive bandage containing the leads under the patient's hairline and took the patient to the recovery room awaken and stable without neurologic sequela or any other complications.
Any assistance would be greatly appreciated.
Here's the operative report:
Complex region pain syndrome type I, unspecified (head and neck)
1. Implantation of neurostimulator electrode array right supraorbital nerve-trial
2. Implantation of neurostimulator electrode array left supraorbital nerve-trial
3. Implantation of neurostimulator electrode array right upper posterior cervical nerve roots-trial
4. Implantation of neurostimulator electrode array left upper posterior cervical nerve roots-trial
IV prophylaxis was administered 30 minutes prior. She was taken to the operating room and allowed to position herself comfortably supine. Sterile prep and drape and local infiltration across the forehead with 10cc of Xylocaine 1% with 1:200,00 epinephrine.
Small incision were made over each temple approximately 2mm in size using a #15 scalpel blade. Though each incision was advanced a curved 4-inch 14-gauge tuohy needle. The needle was advanced in the subcutaneous tissue plane over the known anatomic distribution of the supraorbital nerves bilaterally. Through each needle was advanced a 60cm wide space quadripolar lead array. Needles were withdrawn. Imaging was utilized to assure that the active portion of each lead lay over the known anatomic distribution of the supraorbital nerves bilaterally.
We then sutured the leads in place using interrupted 2-0 silk, placed an occlusive bandage containing the leads across the patient's forehead and assisted the patient in turning prone onto the operating room table. Again sterile prep and drape, local infiltration with an additional 10cc of the above local anesthetic cocktail was performed. A small midline 2mm incision was made through which was advanced additional curved 4inch 14-gauge tuohy needles on right and one left in the subcutaneous tissue plane over the known anatomic distribution of upper posterior cervical nerve roots bilaterally. We then advanced through each needle and additional 60 cm wide space quadripolar lead array. The needles were removed again imaging was used to confirm optimal positioning of each lead. We then sutured the leads in place to the skin surface using interrupted 2-0 silk, placed an occlusive bandage containing the leads under the patient's hairline and took the patient to the recovery room awaken and stable without neurologic sequela or any other complications.
Any assistance would be greatly appreciated.