Jennifer Moore
Guest
Can anyone please help me? I am new to the POS: 49 and POS: 11 billing so the coding of this is not quite clear. How would I code the following OP report for the surgery center not the provider
Summary of the procedure: An informed consent was obtained and the patient was taken in the fluoroscopy suite where she was placed in a prone position and cervical spine was prepped and draped in a usual sterile fashion. C5-C6 was identified. Head of the camera was rotated to open up the intravertebral space.
At this point skin infiltration with lidocaine 1% was given and 20-gauge Tuohy needle was introduced by loss of resistance technique in the epidural space. Injection of Omni Paque 180 in a volume of 3 cc indicted nice epidurogram that filled up the nerve root from C3 through C6 on both sides. The patient was injected with Marcaine 0.125% with Depo Medrol 40mg in a volume of 6 cc after negative test dose and negative aspiration for CSF and blood. Injection was done in increments with several minutes. The patient tolerated the procedure very well. The needle was pulled out.
The patient tolerated the procedure well without complications. The patient was then transferred to the recovery room for further observation and monitoring. Vital signs remained stable pre, post, and during the procedure. After observation in the monitoring room, the patient was allowed to sit, stand, and walk. At the time of discharge, the patient was alert and oriented.
This is the way they are currently coding it:
62310 TC
77003 TC
A4550
99217 -25
Q9966 40units
Thanks for any help anyone can give me.
Summary of the procedure: An informed consent was obtained and the patient was taken in the fluoroscopy suite where she was placed in a prone position and cervical spine was prepped and draped in a usual sterile fashion. C5-C6 was identified. Head of the camera was rotated to open up the intravertebral space.
At this point skin infiltration with lidocaine 1% was given and 20-gauge Tuohy needle was introduced by loss of resistance technique in the epidural space. Injection of Omni Paque 180 in a volume of 3 cc indicted nice epidurogram that filled up the nerve root from C3 through C6 on both sides. The patient was injected with Marcaine 0.125% with Depo Medrol 40mg in a volume of 6 cc after negative test dose and negative aspiration for CSF and blood. Injection was done in increments with several minutes. The patient tolerated the procedure very well. The needle was pulled out.
The patient tolerated the procedure well without complications. The patient was then transferred to the recovery room for further observation and monitoring. Vital signs remained stable pre, post, and during the procedure. After observation in the monitoring room, the patient was allowed to sit, stand, and walk. At the time of discharge, the patient was alert and oriented.
This is the way they are currently coding it:
62310 TC
77003 TC
A4550
99217 -25
Q9966 40units
Thanks for any help anyone can give me.