Help PLEASE. Coding for an ASC and the Dr is wanting me to bill something I don't see so it will match his codes for a Medicare patient............ Please tell me what you see:

Employing fluoroscopy of localization, the skin and immediate subque tissues overlying the lumbar region were infiltrated with 1% lidocain and 30cc bupivacaine 0.25% with 1% epinephrine.

Under Fluoroscopic guidance, a guide needle was directed to the superior articular process, just above its junction with the root of the transverse process at S1, L5, L4, L3 levels to block the L5, L4, L3, L2 medial branches respectively. For the L5 dorsal ramus block, the needle was directed to the lateral surface of the superior articular process just above its junction with the ala of the sacrum.

Canulas were then placed down to the bony junction described above and through careful disection, the corresponding medial branches were directly visualized.

The radiofrequency probe was used to destroy the respective medial branches, through a combination of heating and direct dissection.

Pt under IV conscious sedation.


Thank you for your help!