Op Report
We dissected down to the T8 to get through some of the scar tissue and see a more normal tissue. At this point we were able to get into the epidural space. The paddle was placed in the epidural space. In fact, it was always going to the left side which would not have helped this patient since he has bilateral leg symptoms as well as back pain. At this point, after repeated attempts to move the paddle and it did not move, a second incision was made. This incision was at T8 area, and a T8 laminectomy was done. He had a significant amount of ossification in this area, and in fact, his ligamentum flavum was ossified and was very difficult to get through after the laminectomy was done, and being through the ligamentum flavum to the epidural space, then the paddle was placed again. The paddle still went to the left side, but it was able to be manipulated and placed in the midline. It was secured in place. At this point, a pocket was made on the left side. A transverse incision was made and dissected back down, and it was created. Next, the anchors were placed, and the paddle electrodes were tunneled through the pocket. At this point, the battery was connected and impendence was chcked which was very good at all levels. Next the battery was programmed and placed underneath the skin.
Dr wants to bill 63655, 63685, 95972 and 63042. My question (with stimulators) is the paddle has some length to it. Can it cross multiple segments? Haven't had much experience billing spinal stimulators and I know they can be tricky. Thanks. I look forward to your opinions.