adarshkul
New
Hello all. Appreciate all the advice I can get for this, thanks in advance.
For a pain practice, how many units of 64450 should we bill for the following:
The patient was placed in a prone position with a pillow underneath the knees. The spinous process at the level of the posterior iliac crest was identified by palpation. At the points of approximately 6cm, 7cm, and 8cm lateral to the spinous process at the level of the posterior iliac crest, the area was widely prepped using Betadine ×3. These 3 points were identified via fluoroscopy and needle entry sites were anesthesitized with 1% lidocaine total 5cc.
A 22-gauge 3-1/2 inch needle was then advanced at an oblique angle towards the buttocks at each of these points until each of the needles reached the loss of the posterior iliac crest. Approximately 1 cc of Omnipaque Contrast was then injected at each of these points and showed appropriate spread indicating the branches of the superior cluneal nerve. For each of these needles, after aspiration for blood, a volume of 1 mL from a solution containing 1 cc of 10mg/mL dexamethasone, 2cc bupivacaine 0.75% was injected. A total volume of 3 mL of the solution was injected. The needles were then removed with saline flush. The areas of the needle placement or cleaned and bandages were applied. The patient overall tolerated the procedure very well and there were no complications noted. The patient was able to get off of the bed and ambulate independently with his single-point cane to the postoperative room. There was minimal blood loss.
For a pain practice, how many units of 64450 should we bill for the following:
The patient was placed in a prone position with a pillow underneath the knees. The spinous process at the level of the posterior iliac crest was identified by palpation. At the points of approximately 6cm, 7cm, and 8cm lateral to the spinous process at the level of the posterior iliac crest, the area was widely prepped using Betadine ×3. These 3 points were identified via fluoroscopy and needle entry sites were anesthesitized with 1% lidocaine total 5cc.
A 22-gauge 3-1/2 inch needle was then advanced at an oblique angle towards the buttocks at each of these points until each of the needles reached the loss of the posterior iliac crest. Approximately 1 cc of Omnipaque Contrast was then injected at each of these points and showed appropriate spread indicating the branches of the superior cluneal nerve. For each of these needles, after aspiration for blood, a volume of 1 mL from a solution containing 1 cc of 10mg/mL dexamethasone, 2cc bupivacaine 0.75% was injected. A total volume of 3 mL of the solution was injected. The needles were then removed with saline flush. The areas of the needle placement or cleaned and bandages were applied. The patient overall tolerated the procedure very well and there were no complications noted. The patient was able to get off of the bed and ambulate independently with his single-point cane to the postoperative room. There was minimal blood loss.