# TargetCath eqidural adhesion lysis



## ortho1991 (Jan 22, 2009)

Hi All

I hope someone can help, we have a new pain Doc. and he wants to bill for a TargetCath.  This is what the Op-note say in short.

OPERATION:  TargetCath epidural adhesion lysis, caudal epidural steroid injection, fluoroscopic needle localization, epidurography.

PROC:  The C-arm was tilted to get a lateral view of the coccyx.  A skin wheal was raised just superficial and caudal to the sacral hiatus using lidocaine.  Then, an 18-gauge Tuohy needle was introuced under direct fluoroscopic guidance and advanced through the sacral hiatus.  The needle was further advanced rostrally, and at that point the C-arm was maneuvered to get and AP view of the pelvis.  The needle was visualized midline. Aspiration was negative to blood and/or CSF.

At this point a guide wire was placed through the Tuohy needle and 5mm skin incision was made using a scalpel at the entry point of the guide wire to make for easier access for the dilator.  The dilator was then threaded through the guide wire and advance to increase the size of the insertion point at the sacral hiatus.  The dilator was removed and the TargetCath was threaded through the guide wire into the caudal eqidural space.  Then 8ml of Isovur 180 was injected and the spread of the dye was noted.  The target catheter was manipulated to the left and to the right in an effort to break eqidural adhesion.  After manipulation of the catheter.  The TargetCath tip was more mobile in the epidural space than it was initially, indicating lysis of some of the adhesion.

Then 80mg of Kenalog mixed with 8ml of preservative-free 0.5 lidocaine was injected.  This was followed by another 8ml of 0.5 lidocaine.  Then the catheter was removed.

I believe the caudal inj. is 62311 the the flouroscopic code is 77003, but not sure of anything else.

Any help with this would be greatly appreciated


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## magnolia1 (Jan 22, 2009)

What about 62264?


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## NIENAJADLY (Jan 23, 2009)

*TargetCath*

62264 would be the appropriate code for this epidurolysis procedure.  This code includes the billing for the dye and the radiology (fluoro) so you would not be these in addition.


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## ortho1991 (Jan 23, 2009)

Thank you so much for your help


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