Mike Posted Tue 11th of June, 2013 18:00:32 PM
Physician performed procedures noted below. For the coccygeal nerve block 62311 X1, and 64999 for the 2 intadiscal injections of the coccyeal disks and Fluoroscopy 77002? What to code for the coccygeal nerves on the sacral lateral branch? What would be the correct coding for all the procedures below?? Please help.
PROCEDURE #1: Coccygeal nerve blocks in both the intracanal as well as laterally along the distal sacral border. After obtaining informed consent, the patient was brought to the procedure room, placed in a prone position, and sterile surgical prep and drape. Using fluoroscopic guidance and lateral projection, the sacrococcygeal ligament was identified, and after anesthetizing the skin with 1% buffered lidocaine, a 2 inch, 25-gauge Quincke tip block needle was inserted through the sacrococcygeal ligament and into the distal caudal canal without difficulty or complication. Appropriate positioning was confirmed with the injection of 0.3 mL of myelogram safe contrast dye showing spread within the distal caudal canal. Following this, 0.5 mL of 0.75% Marcaine was injected without difficulty showing washout of the previously placed contrast and remaining in the distal caudal canal.
Attention was then directed to the 2 coccygeal disks, and the initial needle was withdrawn slightly and advanced into these disks without difficulty or complication. Appropriate positioning was confirmed on the lateral views as well as with the injection of 0.1 mL of myelogram safe contrast dye showing spread in the discal/joint space. This was then followed by 0.3 mL of 0.75% Marcaine at each of the disks.
Attention was then directed to the coccygeal nerves (these are the distal sacral lateral branch nerves outside the sacral coccygeal hiatus).
The fluoroscopy beam was changed to a straight AP projection. The lateral border of the distal sacrum was identified and after anesthetizing the skin with 1% buffered lidocaine, 25-gauge, 2 inch Quincke tip needles were advanced until contacting the very lateral edge of the distal sacrum, left and right. This was done without difficulty or complication. Appropriate positioning was confirmed with the injection of 0.3 mL of myelogram safe contrast dye showing spread along the distal edge and lateral edge of the sacrum. This was then followed by 1 mL of 0.75% Marcaine through each of the needles, again without difficulty or complication.
SuperCoder Answered Thu 13th of June, 2013 05:54:05 AM
Please contact Manney-Customer Service at 866-228-9252 Extn : 4165
Mike Posted Fri 14th of June, 2013 20:08:52 PM
I will go elsewhere for help on this question for the coccygel block.