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  1. #1
    Duluth, Minnesota
    Default rhizotomy/neurolysis
    Medical Coding Books
    ok fellow coders - what codes and modifiers do you come up with for the following procedure??

    procedure note reads:
    The skin was cleansed and draped following standard sterile technique. One percent buffered llidocaine was utilized for anesthesia. With fluoroscopic guidance, 22 gauge needles were placed in a bipolar technique to the S1 medial nerves bilaterally. Monopolar technique was utilized at the L5 levels.

    Sensory and motor testing was perfromed. Sensory testing was performed with up to 1 volt at 50 Hertz at 1 millisecond frequency. This was performed at all levels without difficulty. Motor testing was performed from 0 - 3 volts at 2 Hertz at 1 millisecond intervals. No motor activity was observed.

    The patient was sedated. Lesions were created with bipolar technique. Lesions were created for 90 seconds at all locations to a temperature of 80 degrees. The left S1 did require an additional 10 seconds of lesion time for a total of 100 seconds at the left S1 level.

    Eighty millgrams of Depo-Medrol was diluted to 8 mL with 0.5% bupivacaine. This was equally distributed through all six locations. The needles were removed. Once the patient awoke from the anesthesia, the patient described good resolution of symptoms. No obvious complications were observed. The patient had good motor strength. No sensory changes were observed.

    Postprocedure .....(stuff follows, not necessary to post)

    IMPRESSION: Successful and noncomplicated radiofrequrency rhyzotomy/neurolysis as described above.

    thanks for your input!!
    Donna, CPC, CPC-H

  2. #2
    see the 64622-64640 series for your answer

  3. #3
    Duluth, Minnesota
    thanks Mary - yes, I know the codes, I was wondering how others would code it and what "if" any modifiers they would use for it given the documentation. (and I wanted to compare what I came up with, what the doctor "suggested" and what others think)

    thanks again!!
    Donna, CPC, CPC-H

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