codedog
True Blue
doc office says this is. 64483,64484, 64484x2 , 77003
so one else says 64450
any agree, disagree ?
POSTOPERATIVE DIAGNOSIS: Lumbar spondylosis.
OPERATION:
1. Diagnostic nerve blocks of the right L5, L4, L3, and L2 medial branches of the dorsal primary ramus.
2. Fluoroscopic needle guidance.
D.
ANESTHESIA: 2% lidocaine 5 cc and sodium bicarbonate 8.4% 5 cc; monitored anesthesia care.
BLOOD LOSS: None.
FLUIDS GIVEN: 200 cc Lactated Ringer's solution.
URINE OUTPUT: None.
INJECTATE MIXTURE: Preservative-free bupivacaine 0.5% 7 mL and Depo-Medrol 80 mg 1 mL.
PROCEDURE IN DETAIL:
Informed consent was obtained, explained the risks, benefits and alternatives of the procedure to the patient. Operative site was marked in the holding area. The patient was taken to the procedure room and placed in a prone position on the procedure table. The back and buttocks were prepped with ChloraPrep solution, and a sterile drape was applied. A time out was performed to verify the correct patient, procedure, and laterality.
Using fluoroscopy, the spine was examined. The levels in question were visualized from an ipsilateral oblique angle. A skin wheal was raised over the right L5 pedicle, and subcutaneous tissue was anesthetized with a 2% lidocaine mixture. A 3.5-inch 22-gauge spinal needle was advanced with intermittent fluoroscopic guidance towards the 2 o'clock position of the pedicle. Contact with bone was made. The needle was walked off in a cephalomedial orientation and advanced several millimeters to lie on the path of the L4 medial branch at this level. After negative aspiration, 2 mL of the injectate mixture was instilled through the needle.
thanks for your time.
so one else says 64450
any agree, disagree ?
POSTOPERATIVE DIAGNOSIS: Lumbar spondylosis.
OPERATION:
1. Diagnostic nerve blocks of the right L5, L4, L3, and L2 medial branches of the dorsal primary ramus.
2. Fluoroscopic needle guidance.
D.
ANESTHESIA: 2% lidocaine 5 cc and sodium bicarbonate 8.4% 5 cc; monitored anesthesia care.
BLOOD LOSS: None.
FLUIDS GIVEN: 200 cc Lactated Ringer's solution.
URINE OUTPUT: None.
INJECTATE MIXTURE: Preservative-free bupivacaine 0.5% 7 mL and Depo-Medrol 80 mg 1 mL.
PROCEDURE IN DETAIL:
Informed consent was obtained, explained the risks, benefits and alternatives of the procedure to the patient. Operative site was marked in the holding area. The patient was taken to the procedure room and placed in a prone position on the procedure table. The back and buttocks were prepped with ChloraPrep solution, and a sterile drape was applied. A time out was performed to verify the correct patient, procedure, and laterality.
Using fluoroscopy, the spine was examined. The levels in question were visualized from an ipsilateral oblique angle. A skin wheal was raised over the right L5 pedicle, and subcutaneous tissue was anesthetized with a 2% lidocaine mixture. A 3.5-inch 22-gauge spinal needle was advanced with intermittent fluoroscopic guidance towards the 2 o'clock position of the pedicle. Contact with bone was made. The needle was walked off in a cephalomedial orientation and advanced several millimeters to lie on the path of the L4 medial branch at this level. After negative aspiration, 2 mL of the injectate mixture was instilled through the needle.
thanks for your time.