lcole7465
Expert
I have a provider that performed 2 different injections: 64493, 64494 & 64495 on the L4-L5 & L5-S1. The provider also performed 20610 on the Rt knee. I can't get the claim to go out due to it hitting an edit that 64494 & 64495 are a component of 20610 and are not billable together. The 20610 has a -59 modifier attached. I can't find a solution around this other than not billing out the 64494 & 64495.
OP Note: She was placed in a prone position. With fluoroscopic assistance, the L4-L5 and L5-S1 Medial Branch interspace was identified. After Betadine x 3 and 1% lidocaine local infiltration, a 25-gauge 3.5 inch needle was inserted and guided per fluroscopy into the transforaminal space and a AP/Lateral/ and oblique view were done. Not applicable cc of Omnipaque contrast was injected which revealed a normal bilateral epidurogram. This was confirmed with AP and lateral views. There was good injection done at bilateral L4 and L5 medial branches patient tolerated well 1 mL at each site of mixture of 1% lidocaine and 0.25% Marcaine patient tolerated well pain went from an 8/10 to 0/10 at 5 and 20 minutes will keep a pain log will follow up for possible RFA. Procedure: Right knee injection anterior approach, Betadine prep , 1.5 inch 25 gauge needle, no bleeding no complications. Moon injection of 80 mg Depo-Medrol 3 mL lidocaine no bleeding or complication bandage placed.
HELP!!!!
Thanks
OP Note: She was placed in a prone position. With fluoroscopic assistance, the L4-L5 and L5-S1 Medial Branch interspace was identified. After Betadine x 3 and 1% lidocaine local infiltration, a 25-gauge 3.5 inch needle was inserted and guided per fluroscopy into the transforaminal space and a AP/Lateral/ and oblique view were done. Not applicable cc of Omnipaque contrast was injected which revealed a normal bilateral epidurogram. This was confirmed with AP and lateral views. There was good injection done at bilateral L4 and L5 medial branches patient tolerated well 1 mL at each site of mixture of 1% lidocaine and 0.25% Marcaine patient tolerated well pain went from an 8/10 to 0/10 at 5 and 20 minutes will keep a pain log will follow up for possible RFA. Procedure: Right knee injection anterior approach, Betadine prep , 1.5 inch 25 gauge needle, no bleeding no complications. Moon injection of 80 mg Depo-Medrol 3 mL lidocaine no bleeding or complication bandage placed.
HELP!!!!
Thanks
