here is the op report:
DX: low back pain (724.2), left lower extremity pain (729.5) , lumbar facet arthropathy (721.3)
The OEC 9900 Elite fluoroscope was brought into view and the vertebral bodies at L4-L5 and L5-S1 levels were identified utilizing 35 degrees of left lateral rotation. The facet joints were opened maximally. The laser pointer was placed on the corresponding skin sites. After adequate anesthesia was obtained through the skin utilizing 1cc of 1% bicarbonated lidocaine, 22 hauge spinal needles 5 inches in length were passed through the skin, subcutaneous tissue, and negotiated into the facet joints with great care. The stylets were removed. Aspiration revealed no blood, pain, paresthesias, urine, or other bodily contents. Omnipaque 240 was injected to peform an arthrogram, which was within normal limits. At this point, 20cc of Celestone and 2cc of Marcaine 5% were injected. The needles were removed.
Then, attention was turned to the L5-S1 neural foramen. It wasopened maximally utilizing the OEC 9900 Elite flurosocope with 35 degrees of left cephalic tilt. Local skin anesthesia was obtained with 1cc of 1% lidocaine and the 22 gauge spinal needle, 5 inches in length was passed down the laser point and negotiated into the left L5-S2 foramen. Neurograms were placed after the stylet was removed, which revealed ona spiration, no blood, pain paresthesias, urine or other bodily contents. Then 1cc of Omnipaque 240 was injected and the neurogram was adequate. There was no intravenous or intravascular flow, C-betamethasone 6mg, 35mcg of fentanyl and 2cc of 0.5% Marcaine were injected at this point. The needle was removed. antibiotic ointment and band aids were placed over the site of this needle insertion.
What do you guys think?
Which also leads me to another question can 62311 & 64483 be billed together, I read an article from the Coding Institute that says we can using modifier 59 on 64483, (for example, let's say doc did caudal epidural & transforaminal at L3-L4
