# Crazy Question



## nyyankees (Feb 5, 2010)

do all injections need floro? nerve, facet, etc. Curious..thanks


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## Walker22 (Feb 5, 2010)

My Pain Management physicians use flouro whenever possible. Certainly facets and epidurals need them for the best needle placement.


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## brockorama01 (Feb 8, 2010)

Actually, I believe the new standard of care for Medicare for facet/Medial branch blocks requires fluoro.

For epidurals, fluoro isn't required but you can't tell what's going on in a pt's back without it.  The best example is a pt with low back pain with shooting left leg pain.  The pain specialist may try to target the left side of the spine, however, the medication may not go to the left side of the spine due to scar tissue, strange anatomy or bad needle placement.  Without fluoro, you would never know if the medication got to the proper area.

Brock Berta, CPC


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## hgolfos (Feb 10, 2010)

I agree with Brock, you can't properly place a facet joint without flouro, and epidurals do not require it, but it is advantageous.  I would add that transforaminal injections and true SI joint injections also require flouro.  Again it is advantageous but not required for other nerve blocks, such as interscalene, peripheral, femoral, and so on, as well as other joint injections such as shoulder, hip and knee.

Hope this helps.


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