Queizati
Networker
Findings: Moderate sized calcific lesion was seen which was continuous with the supraspinatus tendon.
Procedure note: The right SASDB and above-described calcification were evaluated under ultrasound using a 12mHz linear array transducer. The right subacromial region was then prepped with chloroprep. The probe was positioned in the coronal plane parallel to the long axis of the supraspinatus. A 25G 1.5" needle was then inserted about 1-2 cm from the lateral end of the probe and directed towards the SASDB using an in-plane approach under direct ultrasound visualization and lidocaine 1% was given for local anesthetic. Then, an 18g 1.5" needle was inserted and directed toward the calcification. Barbotage was performed and accompanied by injecting about 4mL of normal saline to help break up the calcification. After sufficient needling, 5mL total was then placed consisting of 1 mL of 40 mg Kenalog and 4 mL 1% lidocaine without resistance. Excellent flow and fluid distention was noted in the bursal space confirming placement. There was no bleeding or complications. Post-procedure impingement maneuvers yielded no residual pain. Post-procedure care instructions were given, including applying ice for 15 minute intervals up to 3 times daily for the next 48 hours as needed.
Can this procedure be captured by 20611 or is another code needed to describe the needling done to the calcium deposit?
Procedure note: The right SASDB and above-described calcification were evaluated under ultrasound using a 12mHz linear array transducer. The right subacromial region was then prepped with chloroprep. The probe was positioned in the coronal plane parallel to the long axis of the supraspinatus. A 25G 1.5" needle was then inserted about 1-2 cm from the lateral end of the probe and directed towards the SASDB using an in-plane approach under direct ultrasound visualization and lidocaine 1% was given for local anesthetic. Then, an 18g 1.5" needle was inserted and directed toward the calcification. Barbotage was performed and accompanied by injecting about 4mL of normal saline to help break up the calcification. After sufficient needling, 5mL total was then placed consisting of 1 mL of 40 mg Kenalog and 4 mL 1% lidocaine without resistance. Excellent flow and fluid distention was noted in the bursal space confirming placement. There was no bleeding or complications. Post-procedure impingement maneuvers yielded no residual pain. Post-procedure care instructions were given, including applying ice for 15 minute intervals up to 3 times daily for the next 48 hours as needed.
Can this procedure be captured by 20611 or is another code needed to describe the needling done to the calcium deposit?
