suela923@aol.com
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Normally the vetebroplasty code, 22520 includes a bone biopsy but in this case the doctor clearly states this was not a biopsy but was an aspiration. Would it be appropriate to bill 38220 as well? Thank you. Sue
T12 and L1 vertebroplasties; L1 bone marrow aspiration
History: Painful T12 and L1 compression fractures.
Technique: Timeout was performed. Skin over the low back prepped and draped sterilely. 2% lidocaine used as local anesthetic. Moderate sedation also administered. Under biplane fluoroscopy, 12-gauge transpedicular trochars were advanced into the T12 and L1 vertebral body, bilateral L1 and unilateral on the left at T12. From the right L1 trocar, aspiration of the L1 bone marrow was performed. Bone cement was instilled into all 3 trochars under intermittent fluoroscopic guidance. X-rays were obtained. Trochars were removed. No complications occurred.
Findings: There is rotatory levoscoliosis. Bones are demineralized. There is a severe T12 compression deformity and a mild to moderate L1 compression deformity. Bone marrow aspiration was obtained from the L1 vertebral body as described above. The bone was so soft that biopsy could not be performed. Bone cement partially fills the L1 vertebral body and the left portion of the T12 vertebral body, in excellent position. No evidence of a complication.
Successful and uncomplicated bone marrow aspiration at L1. Successful and uncomplicated T12 and L1 vertebroplasties. The patient reported significant pain relief 2 hours after the procedure, upon discharge.
T12 and L1 vertebroplasties; L1 bone marrow aspiration
History: Painful T12 and L1 compression fractures.
Technique: Timeout was performed. Skin over the low back prepped and draped sterilely. 2% lidocaine used as local anesthetic. Moderate sedation also administered. Under biplane fluoroscopy, 12-gauge transpedicular trochars were advanced into the T12 and L1 vertebral body, bilateral L1 and unilateral on the left at T12. From the right L1 trocar, aspiration of the L1 bone marrow was performed. Bone cement was instilled into all 3 trochars under intermittent fluoroscopic guidance. X-rays were obtained. Trochars were removed. No complications occurred.
Findings: There is rotatory levoscoliosis. Bones are demineralized. There is a severe T12 compression deformity and a mild to moderate L1 compression deformity. Bone marrow aspiration was obtained from the L1 vertebral body as described above. The bone was so soft that biopsy could not be performed. Bone cement partially fills the L1 vertebral body and the left portion of the T12 vertebral body, in excellent position. No evidence of a complication.
Successful and uncomplicated bone marrow aspiration at L1. Successful and uncomplicated T12 and L1 vertebroplasties. The patient reported significant pain relief 2 hours after the procedure, upon discharge.