# Cisternogram-a radiology group



## pattypierson (Feb 15, 2013)

We are a radiology group and need to know if we are to bill using 62270 or 62311?  We are not sure of the difference in these codes and can we bill the A9548 in addition to either of those codes? Report is below. Thank you!!!! 

FLUOROSCOPICALLY-GUIDED LUMBAR PUNCTURE FOR CISTERNOGRAM

Indication:  Evaluation for normal pressure hydrocephalus. 

Comparison:  None.

The patient is competent and provides written and verbal consent to the procedure. Time Out was performed.

Placed prone on the fluoroscopy table, the L4-5 level was selected for access into the thecal sac. The skin was marked and prepped with Betadine. Sterile draped fully. Cutaneous anesthesia achieved with infiltration of 1% Xylocaine. A 20-gauge spinal needle was introduced without difficulty in one pass into the thecal sac yielding clear CSF. The radiopharmaceutical was injected without difficulty. Approximately 0.5 cc of the patients own CSF was used to flush the needle. Stylet was replaced and the needle was removed. 

The patient tolerated the procedure well.

1.5 minutes of fluoroscopy time was utilized. 

IMPRESSION:

Successful fluoroscopic access to the thecal sac with instillation of Indium-111 DTPA. Details of the injection will be provided separately in the nuclear medicine report. 
Preliminary imaging was performed over the spine later same day. The patient was discharged after that preliminary imaging in good condition with no complication. He will return for imaging later this week.


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