# L3 adn L5 dorsal root ganglion radiofrequency and selected nerve root block



## ortho1991 (Dec 15, 2014)

I hope someone can help me with this.

The patient was brought to the operating room and placed in the prone position. A small pillow was
placed underneath the patient's abdomen. The skin was prepped with povidone-iodine three times, and
draped in a sterile fashion. The target site was identified at the right L3 pedicle. The target site was at
the 6 o'clock position. Using a 25-gauge, 1.5 inch needle, I anesthetized subcutaneously. Then a 20
gauge, 3.5 inch SMK type needle was directed to the dorsal ganglion just medial to the pedicle and the
neural foramen. Testing was carried out for sensory and motor. Sensory was at approximately 1 MHz
and motor at 1.5 MHz. Then pulse radiofrequency was carried out for two minutes at 42 degrees
Fahrenheit. Then continuous radiofrequency was performed. This was up to patient tolerance, which
was at 50 degrees for 90 seconds. Then, nerve root block was done with 1 mL of 1% Lidocaine. The
needle was withdrawn. The same procedure was carried for the right L5 dorsal root ganglion.
The patient tolerated the procedure well and was transferred to the recovery room in stable condition.
The patient was monitored before being discharged to home. Discharge instructions were given to the
patient and a followup appointment was scheduled prior to discharge.

I'm thinking the unlised code 64999 because he says pulse radiofrequency but then he says continuous radiofrequency performed.

Please any suggestions with this will be appreciated

Thank you


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## Amy Pritchett (Dec 15, 2014)

If you look to the guidelines in your CPT manual (2014 pg. 362) It states that i the physician performs Radiofrequency , use 64999 and you cannot code separate injections on the same day with the 64999.

Hope this helps


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