What code(s) would we bill for the following procedure.
The patient was placed in the prone position on the procedure table. Back was prepped and draped in standard sterile fashion. 1% lidocaine 15 mL total was used for local infiltration. Two incisions about 3 cm in length, were made over the left and right paraspinal area of the lumbar region laterally from postoperative scar. The incisions were carried through the skin and subcutaneous tissues toward the fascia. Hemostasis was obtained using electrocoagulation. Two 14-gauge Tuohy needles were advanced into the left and right paraspinal area of the lumbar region laterally from postoperative scar. Two 8 electrode leads were inserted through the Tuohy needles and Tuohy needles were withdrawn. Good position of the leads was confirmed with C-arm. Both leads were connected to temporary unit and complex programming of peripheral nerve stimulator leads was performed. The patient reported 100% coverage of the pain areas and was very satisfied with this coverage. At this point, both leads were attached to the fascia using anchoring devices and 0 Nurolon sutures. After additional local infiltration of 1% lidocaine, incision in the left paraspinal area of lumbar region was extended to left supragluteal area. Using blunt and sharp dissection, we created a sufficient size pocket to accommodate the generator. Using kit provided tunneling device, we brought a lead from the wound in right paraspinal area of lumbar region to the wound in the left supragluteal area. Both leads were connected to Restore Advanced Rechargeable generator and the generator was affixed to the fascia using 2 interrupted sutures of 0 Nurolon. Both wounds were irrigated using antibiotic solution and closed with interrupted sutures of 2-0 Vicryl. The subcutaneous tissue was approximated with a running suture of 3-0 Vicryl. Before final skin closure, we injected 20 mL of 0.25% Sensorcaine in skin edges. Skin was approximated with staples. Patient tolerated the procedure well.
diagnosis-post laminectomy syndrome
procedure done 5/15/12
The patient was placed in the prone position on the procedure table. Back was prepped and draped in standard sterile fashion. 1% lidocaine 15 mL total was used for local infiltration. Two incisions about 3 cm in length, were made over the left and right paraspinal area of the lumbar region laterally from postoperative scar. The incisions were carried through the skin and subcutaneous tissues toward the fascia. Hemostasis was obtained using electrocoagulation. Two 14-gauge Tuohy needles were advanced into the left and right paraspinal area of the lumbar region laterally from postoperative scar. Two 8 electrode leads were inserted through the Tuohy needles and Tuohy needles were withdrawn. Good position of the leads was confirmed with C-arm. Both leads were connected to temporary unit and complex programming of peripheral nerve stimulator leads was performed. The patient reported 100% coverage of the pain areas and was very satisfied with this coverage. At this point, both leads were attached to the fascia using anchoring devices and 0 Nurolon sutures. After additional local infiltration of 1% lidocaine, incision in the left paraspinal area of lumbar region was extended to left supragluteal area. Using blunt and sharp dissection, we created a sufficient size pocket to accommodate the generator. Using kit provided tunneling device, we brought a lead from the wound in right paraspinal area of lumbar region to the wound in the left supragluteal area. Both leads were connected to Restore Advanced Rechargeable generator and the generator was affixed to the fascia using 2 interrupted sutures of 0 Nurolon. Both wounds were irrigated using antibiotic solution and closed with interrupted sutures of 2-0 Vicryl. The subcutaneous tissue was approximated with a running suture of 3-0 Vicryl. Before final skin closure, we injected 20 mL of 0.25% Sensorcaine in skin edges. Skin was approximated with staples. Patient tolerated the procedure well.
diagnosis-post laminectomy syndrome
procedure done 5/15/12