NESmith
Expert
Exam: Attempted CT-Directed Intra-Articular Right Shoulder Injection for MR Arthrography
Procedure: The risks and benefits of this procedure was discussed with the patient, and both verbal and written consent were obtained. After utilizing local anesthesia and sterile technique, and after CT guidnace, the patient was placed in a prone position. The patient is extremely claustrophobic. Becasue we were worried about the claustrophobia and the patient did not want to tke Valium we walked the patient over to the MRI room. Upon seeing the MRI, patient thought she could not tolerate the MRI.
Impression: CT-guided contrast injection of the right should for arthrogram was cancelled because patient was so claustrophobic and upset that she did not thik she could get into the MRI. Additionally, patient was very uncomfortable being positioned for the contrast injection.
Recommendation: I believe the patient could tolerate a contrast injection if given pain medication first. CT arthrogram could therefore then be considered. I do not think patient wll be able to tolerate MR arthrogram, but we would be willing to attempt it with Valium as long as CT arthrogram would be acceptable if the MR arthrogram fails.
Codes billed: 77012-52
23350-5251
I am unsure if the 52 modifier is appropriate. Please advise and Thank You.
Procedure: The risks and benefits of this procedure was discussed with the patient, and both verbal and written consent were obtained. After utilizing local anesthesia and sterile technique, and after CT guidnace, the patient was placed in a prone position. The patient is extremely claustrophobic. Becasue we were worried about the claustrophobia and the patient did not want to tke Valium we walked the patient over to the MRI room. Upon seeing the MRI, patient thought she could not tolerate the MRI.
Impression: CT-guided contrast injection of the right should for arthrogram was cancelled because patient was so claustrophobic and upset that she did not thik she could get into the MRI. Additionally, patient was very uncomfortable being positioned for the contrast injection.
Recommendation: I believe the patient could tolerate a contrast injection if given pain medication first. CT arthrogram could therefore then be considered. I do not think patient wll be able to tolerate MR arthrogram, but we would be willing to attempt it with Valium as long as CT arthrogram would be acceptable if the MR arthrogram fails.
Codes billed: 77012-52
23350-5251
I am unsure if the 52 modifier is appropriate. Please advise and Thank You.