martnel
Guest
Does anybody have an idea how to code this? I am coding Pain Management for 5 yrs now, but I have never seen this!
POSTOPERATIVE DIAGNOSIS:
1. Herniated lumbar disc.
2. Degenerative lumbar disc times three.
PROCEDURE:
Intradiscal regenerative therapy.
DESCRIPTION OF PROCEDURE:
After informed consent was obtained, the patient was placed prone on the fluoroscopic table. His back was then prepped and draped in a sterile fashion with full sterile prep and DuraPrep.
Via right paramedian approach, the disc spaces of L3-4, L4-5 and L5-S1 were identified. 18-gauge Angiocaths were utilized for skin cannula, after infiltration with a total of 3 cc of 1% Xylocaine via 27-gauge needle. 22-gauge spinal needles were easily advanced under direct fluoroscopic guidance to the disc spaces without paresthesias. The L5-S1 disc space required repositioning once because on AP view, it appeared that the needle was not optimally positioned. 0.5 cc of normal saline was instilled in L5-S1 to confirm we were not in the annular ring.
Tissue allograft product ID#......
L3-4 intradiscal therapy:
One cc of micronized BioD Genesis tissue matrix was instilled. Of note, there was moderate reproduction of atypical pain.
L4-5 intradiscal therapy:
One cc of micronized BioD Genesis tissue matrix was instilled without reproduction of the patient's typical symptoms.
L5-S1 intradiscal therapy:
Utilizing the same technique, 1 cc of micronized tissue matrix BioD Genesis was instilled without reproduction of the patient's typical symptoms.
After the procedure was performed, the patient was transferred to the recovery room in stable condition.
POSTOPERATIVE DIAGNOSIS:
1. Herniated lumbar disc.
2. Degenerative lumbar disc times three.
PROCEDURE:
Intradiscal regenerative therapy.
DESCRIPTION OF PROCEDURE:
After informed consent was obtained, the patient was placed prone on the fluoroscopic table. His back was then prepped and draped in a sterile fashion with full sterile prep and DuraPrep.
Via right paramedian approach, the disc spaces of L3-4, L4-5 and L5-S1 were identified. 18-gauge Angiocaths were utilized for skin cannula, after infiltration with a total of 3 cc of 1% Xylocaine via 27-gauge needle. 22-gauge spinal needles were easily advanced under direct fluoroscopic guidance to the disc spaces without paresthesias. The L5-S1 disc space required repositioning once because on AP view, it appeared that the needle was not optimally positioned. 0.5 cc of normal saline was instilled in L5-S1 to confirm we were not in the annular ring.
Tissue allograft product ID#......
L3-4 intradiscal therapy:
One cc of micronized BioD Genesis tissue matrix was instilled. Of note, there was moderate reproduction of atypical pain.
L4-5 intradiscal therapy:
One cc of micronized BioD Genesis tissue matrix was instilled without reproduction of the patient's typical symptoms.
L5-S1 intradiscal therapy:
Utilizing the same technique, 1 cc of micronized tissue matrix BioD Genesis was instilled without reproduction of the patient's typical symptoms.
After the procedure was performed, the patient was transferred to the recovery room in stable condition.