mgrimaldi
Contributor
I need help coding the following procedure.
PROCEDURE: Today the patient was placed in prone posture on the fluoroscopy table, and the head and neck prepped in customary sterile fashion. I carefully palpated area of greatest pain on right and identified it as being the occipital emergence on right beneath nuchal ridge and at the C1-2 inner space. I looked at where the shunt appeared to be placed and noted that it does have a loop or curl at C1-2. It appears to be within the musculature. I carefully placed a 25-gauge needle at this point under fluoroscopic guidance to make sure that the shunt itself was not contacted. I injected 1 cc of Omnipaque dye superficially and deeply to mark the area where the patient felt needle placement had caused the greatest pain. After marking these points, I injected lidocaine 4%, Marcaine 0.75%, and Depo-Medrol 40 mg, 3 cc total divided between the points. Needles were withdrawn.
Patient is having pain 6 month's post op for shunt placement due to increased cranial pressure. Provider coded as a cervical facet 64490. I am doubting that this is accurate.
Any takers out there?
PROCEDURE: Today the patient was placed in prone posture on the fluoroscopy table, and the head and neck prepped in customary sterile fashion. I carefully palpated area of greatest pain on right and identified it as being the occipital emergence on right beneath nuchal ridge and at the C1-2 inner space. I looked at where the shunt appeared to be placed and noted that it does have a loop or curl at C1-2. It appears to be within the musculature. I carefully placed a 25-gauge needle at this point under fluoroscopic guidance to make sure that the shunt itself was not contacted. I injected 1 cc of Omnipaque dye superficially and deeply to mark the area where the patient felt needle placement had caused the greatest pain. After marking these points, I injected lidocaine 4%, Marcaine 0.75%, and Depo-Medrol 40 mg, 3 cc total divided between the points. Needles were withdrawn.
Patient is having pain 6 month's post op for shunt placement due to increased cranial pressure. Provider coded as a cervical facet 64490. I am doubting that this is accurate.
Any takers out there?