umcanes4
Guru
Hello! I was wondering if anyone has come across the procedure below. We were coding this as:
64425-RT
64450-RT
64640-RT
76942-26
But the physicians are stating the 64640 should be coded twice, 1) for the cryoablation and 2) for the allogen ablation. Would love to get your thoughts on this. TIA!!
Procedure Name: Elective Right targeted peri-spermatic, groin & ilioinguinal blocks, cryoablation & allogen ablation under realtime ultrasound guidance.
Procedure Description: Patient was taken to the OR, placed in supine position, induced under IV anesthesia, and prepped & draped in standard surgical fashion. A right spermatic cord & ilioinguinal block (genitofemoral, ilioinguinal & inferior hypogastric nerves) was performed with a mixture of 1% lidocaine, 0.25% marcaine & 4mg decadron (30cc). Under ultrasound guidance 1ml allogen (in 3cc NS) was injected in the medial peri-spermatic cord area. Under ultrasound guidance the cryo-ablation needle was percutaneously placed in the left upper scrotal area, lateral to the spermatic cord & superior in the groin area. Cryoablation was performed for 1.5 minutes in each location twice under realtime ultrasound imaging to ensure good blood flow within the spermatic cord (to ablate branches of the (genitofemoral, ilioinguinal & inferior hypogastric nerves). Under ultrasound guidance the cryo-ablation needle was placed next to the the ilioinguinal nerve (2 cm medial to the right anterior iliac spine) & cryoablation was performed for 1.5 minutes twice. The probe was then removed and bacitracin was placed over the skin puncture sites. Fluff dressing & a jock support were applied to the scrotum.
64425-RT
64450-RT
64640-RT
76942-26
But the physicians are stating the 64640 should be coded twice, 1) for the cryoablation and 2) for the allogen ablation. Would love to get your thoughts on this. TIA!!
Procedure Name: Elective Right targeted peri-spermatic, groin & ilioinguinal blocks, cryoablation & allogen ablation under realtime ultrasound guidance.
Procedure Description: Patient was taken to the OR, placed in supine position, induced under IV anesthesia, and prepped & draped in standard surgical fashion. A right spermatic cord & ilioinguinal block (genitofemoral, ilioinguinal & inferior hypogastric nerves) was performed with a mixture of 1% lidocaine, 0.25% marcaine & 4mg decadron (30cc). Under ultrasound guidance 1ml allogen (in 3cc NS) was injected in the medial peri-spermatic cord area. Under ultrasound guidance the cryo-ablation needle was percutaneously placed in the left upper scrotal area, lateral to the spermatic cord & superior in the groin area. Cryoablation was performed for 1.5 minutes in each location twice under realtime ultrasound imaging to ensure good blood flow within the spermatic cord (to ablate branches of the (genitofemoral, ilioinguinal & inferior hypogastric nerves). Under ultrasound guidance the cryo-ablation needle was placed next to the the ilioinguinal nerve (2 cm medial to the right anterior iliac spine) & cryoablation was performed for 1.5 minutes twice. The probe was then removed and bacitracin was placed over the skin puncture sites. Fluff dressing & a jock support were applied to the scrotum.