# Styloid process block



## KJZcoder (Apr 8, 2010)

Hi
I'm not sure how to code this
dx:Eagle Syndrome with RT STYLOID PROCESS FRACTURE
Cervical DDD with Radiculopathy
cpt:the provider did " Rt Styloid process block"
thanx in advance for any info that can be provided
kel

Kelly Z.
AMRS/RT WELTER


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## dwaldman (Apr 8, 2010)

http://www.aetna.com/cpb/medical/data/400_499/0400.html


"Ernest or Eagle's syndrome, a problem similar to temporomandibular joint pain, involves the stylomandibular ligament, a structure that connects the styloid process at base of the skull with the hyoid bone. Symptoms of Ernest syndrome, in decreasing order of occurrence, are: temporomandibular joint and temporal pain, ear and mandibular pain, posterior tooth sensitivity, eye pain, and throat pain (especially when swallowing)."

Dx Eagle's Syndrome 756.71
 Cervical DDD w/Radiculopathy 722.4

CPT Injection of attachment Stylohyoid ligament to the styloid process or around the Glossopharyngeal nerve

"Eagle syndrome derives it name from Watt Weems Eagle an Amercian Otolaryngologist who was born in 1898. He first published his data in 1937 with a series of 200 patients presenting with symptoms related to a calcified stylohyoid ligament or elongated styloid process. These symptoms include a pharyngeal foreign body sensation, dysphagia, pain on head rotation, otalgia, dizziness and headaches. The symptoms are attributed to impingement of the glossopharyngeal nerve as it runs close to the styloid process and calcified ligament."


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## dwaldman (Apr 8, 2010)

The dx for styloid process fracture in the region you are describing I was looking at 801.00. For the CPT it sounds like this injection would be 20551 if the attachment of the stylohyoid ligament to the styloid process would be considered insertion or origin. Or possibly 20550. I assume this is considered different from: "Glossopharyngeal neuralgia is a condition in which there are repeated episodes of severe pain in the tongue, throat, ear, and tonsils, which can last from a few seconds to a few minutes." You could check to see if he mentions that he is blocking the Glossopharyngeal nerve, which I maybe 64450 could be used. Other nerves that I noticed were in this area where the accessory, vagus, hypoglossal.


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## KJZcoder (Apr 14, 2010)

JUST WANTED TO MAKE SURE 
I SAID THANK YOU TO dwaldman!!!!!!


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## LJ2009 (Aug 14, 2012)

*Dx Eagle's Syndrome 756.71* 

Eagle's Syndrome is different from icd-9 756.71 Eagle-Barrett Syndrome or Prune Belly Syndrome: 

This syndrome, also known as Eagle-Barrett syndrome, consists of a triad of features: anterior abdominal wall musculature deficiency or absence, urinary tract anomalies and bilateral cryptorchidism. This condition is named after the wrinkled prune-like appearance of the abdominal wall. The major prognostic factor is the degree of dilation of the urinary tract. The incidence of prune belly syndrome is 1 in 40,000 live births, with 95 percent of cases occurring in males. Of this, 20 percent are stillborn, 30 percnet die of renal failure or urosepsis within the first two years of life, and the remaining 50 percent have varying degrees of urinary pathology. Two hypotheses exist regarding the etiology of prune belly syndrome: 

· Urinary tract obstruction--hypoplastic or dysplastic prostate causes an obstruction of the urethra which creates a urinary tract obstruction leading to overdistension of the bladder. The upper urinary tract stretches the abdominal wall and causes damage to the abdominal musculature and interferes with the descent of the testicles.  

· Primary mesodermal developmental defect--an insult between 6 and 10 weeks gestation disrupts the development of the lateral plate mesoderm from which arises both the abdominal wall, and the genitourinary tract including the prostate. 

*Eagle's syndrome (or styloid syndrome) is the pain that results from an elongated styloid process of the temporal bone, 733.99. An additional code is assigned for the associated condition that may be either glossopharyngeal neuralgia, 352.1, or impingement (compression) of the carotid artery, 447.1, causing head pain.  *


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## dwaldman (Aug 15, 2012)

LJ2009, thank for the ICD-9 correction and clarfication. Very informative.


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