southsidepain
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A provider performed a Sacroiliac Joint Radiofrequency Lesioning with Fluoroscopy. Medicare is denying the first two lines listed below as duplicate. Is this the appropriate way to code this procedure? Provider places the need in the joints then burns the needle. Any suggestions/thoughts?
64640 -RT, -76 x 1
64640 -RT, -76 x 1
64640 -RT x1
J3301
The area was prepped with chloraprep and draped in a sterile fashion. 0.33% lidocaine with bicarbonate 10 ml(s) was injected in the skin and subcutaneous tissue at each level. An 18 gauge curved 10 cm active tip radiofrequency needle was inserted in the SI joint and motor stimulation at 2 Hz revealed no leg stimulation. 8 cc(s) of lidocaine 1% was injected at each level prior to the lesion. A lesion was performed utilizing 80 degree Celsius tempature for 105 seconds following the stimulation. A total of 4 lesions were created at this level.
Following the lesioning, 1cc of triamcinolone and 3cc of .25% bupivicaine were mixed and 1cc of the solution was injected through each needle.
The needles were removed and dressings were applied. The patient tolerated the procedure well and was discharged to the recovery room where the patient was monitored for respiratory and hemodynamic stability. Instructions and follow up were given prior to the patient's discharge.
64640 -RT, -76 x 1
64640 -RT, -76 x 1
64640 -RT x1
J3301
The area was prepped with chloraprep and draped in a sterile fashion. 0.33% lidocaine with bicarbonate 10 ml(s) was injected in the skin and subcutaneous tissue at each level. An 18 gauge curved 10 cm active tip radiofrequency needle was inserted in the SI joint and motor stimulation at 2 Hz revealed no leg stimulation. 8 cc(s) of lidocaine 1% was injected at each level prior to the lesion. A lesion was performed utilizing 80 degree Celsius tempature for 105 seconds following the stimulation. A total of 4 lesions were created at this level.
Following the lesioning, 1cc of triamcinolone and 3cc of .25% bupivicaine were mixed and 1cc of the solution was injected through each needle.
The needles were removed and dressings were applied. The patient tolerated the procedure well and was discharged to the recovery room where the patient was monitored for respiratory and hemodynamic stability. Instructions and follow up were given prior to the patient's discharge.