lesliefence
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Need another opinion on this. I am thinking the only thing that can be billed from this procedure is the marker, but I'm not 100% sure. This is for a pro-fee done at a hospital and only bill for the procedure part. ANy suggestions?
Procedure: CT GUIDED BIOPSY AND/OR NEEDLE PLACEMENT, CT GUIDED BIOPSY AND/OR NEEDLE PLACEMENT History: liver lesion Sedation: 1 mg Versed 50 mcg fentanyl Fluoroscopy time: none Procedure/Findings: Patient's images were reviewed which show high dome liver lesion as well as a right lobe liver lesion more inferiorly and laterally. The latter lesion is somewhat small but seen on prior CT scan. Patient is referred for biopsy of liver lesion. Note is made that the lesions are quite high in septic to significant respiratory motion and diaphragm and lung must be transgressed to access. The right lateral lobe liver lesion was selected. Patient's was placed in CT table. Scans performed the. Lesion is very faintly identified. Repeat scanning after marker placed could not reidentify the lesion. Contrast administered and repeat scanning performed and the lesion still not well delineated. Patient was subsequently taken to a different scanner several hours later to see if a high-resolution scanner with Center slices would be helpful. Again the lesion was faintly seen in one series but could not consistently be identified and because of this biopsy not performed at this time. Estimated blood loss: none Specimens: specimens as described above, otherwise none taken Post-operative diagnosis: Liver lesions as described above.
Procedure: CT GUIDED BIOPSY AND/OR NEEDLE PLACEMENT, CT GUIDED BIOPSY AND/OR NEEDLE PLACEMENT History: liver lesion Sedation: 1 mg Versed 50 mcg fentanyl Fluoroscopy time: none Procedure/Findings: Patient's images were reviewed which show high dome liver lesion as well as a right lobe liver lesion more inferiorly and laterally. The latter lesion is somewhat small but seen on prior CT scan. Patient is referred for biopsy of liver lesion. Note is made that the lesions are quite high in septic to significant respiratory motion and diaphragm and lung must be transgressed to access. The right lateral lobe liver lesion was selected. Patient's was placed in CT table. Scans performed the. Lesion is very faintly identified. Repeat scanning after marker placed could not reidentify the lesion. Contrast administered and repeat scanning performed and the lesion still not well delineated. Patient was subsequently taken to a different scanner several hours later to see if a high-resolution scanner with Center slices would be helpful. Again the lesion was faintly seen in one series but could not consistently be identified and because of this biopsy not performed at this time. Estimated blood loss: none Specimens: specimens as described above, otherwise none taken Post-operative diagnosis: Liver lesions as described above.
