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If you have the following operating report:
Operation: Bilateral L4, L5, S1 selective nerve root block.
OPERATIVE PROCEDURE:
The patient was taken to the operating room. He was placed in the prone position. He received IV sedation from the anesthesia department. Fluoroscopic guidance was utilized to advance the 5 inch 22 gauge spinal needle into the bilateral L4 L5 and L5 S1 and S1 neuroforamen. Needle placement was confirmed in AP, oblique, and lateral views. No blood, CSF, or paraesthesias were noted. Omnipaque 240 and 1 cc was injected at each level, which showed good epidural spread and outlining the exiting nerve root. No vascular uptake was noted. Kenalog 10 mg and 1 cc of lidocaine was injected at each level. The patient tolerated the procedure well. The patient will follow up in two weeks.
The office coded, 64483-50, 64484-50 x2, 77003-26
does that S1 neuroforamen count as another level to justify the 64484-50 x2?
Thanks for your help!
Operation: Bilateral L4, L5, S1 selective nerve root block.
OPERATIVE PROCEDURE:
The patient was taken to the operating room. He was placed in the prone position. He received IV sedation from the anesthesia department. Fluoroscopic guidance was utilized to advance the 5 inch 22 gauge spinal needle into the bilateral L4 L5 and L5 S1 and S1 neuroforamen. Needle placement was confirmed in AP, oblique, and lateral views. No blood, CSF, or paraesthesias were noted. Omnipaque 240 and 1 cc was injected at each level, which showed good epidural spread and outlining the exiting nerve root. No vascular uptake was noted. Kenalog 10 mg and 1 cc of lidocaine was injected at each level. The patient tolerated the procedure well. The patient will follow up in two weeks.
The office coded, 64483-50, 64484-50 x2, 77003-26
does that S1 neuroforamen count as another level to justify the 64484-50 x2?
Thanks for your help!