64517 - superior hypogastric plexus block
This is the note I have from the doctor. I coded this without any modifer 50 or RT or LT. I did that because I was thinking this code couldn't be bilateral per physician fee schedule. Is that correct or not correct? The MD wants to know why I don't use RT and LT?
Thanks if anyone can help out.
An informed consent was obtained. IV access was established. Patient was placed in the prone position on the fluoroscopy table. Monitors were applied. The low back was prepped and draped in the usual sterile fashion. Then 2% lidocaine was infiltrated intradermally and deeper midway between the lower costal margin and the iliac crest and just lateral to the bulk of the right paraspinal musculature. A 22G 7' needle was inserted through the skin wheal and advanced slowly under fluoroscopic guidance in an anterior, medial, and slightly superior direction until the tip of the needle lay approximately 1cm anterior to the right anterolateral aspect of the vertebral column at the inferior L5 level. This was confirmed in AP and lateral views. A small amount of Omnipaque 300 was injected, and appropriate spread of contrast was observed anterior to L5 in appropriate pattern. After negative aspiration, 8ml of 0.5% Marcaine solution was injected in 2- to 3-cc increments with negative aspiration before and after each small bolus injection. The needle was withdrawn. This was repeated in the same fashion on the left. Band-Aids were applied. There were no complications.
Inpt & Outpt Coder