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percutaneous fusion L4-5 with bone product

Anh Posted Mon 08th of August, 2011 22:31:09 PM

what cpt code can I use for percutaneous fusion with Trinity bone product? please help

SuperCoder Answered Tue 09th of August, 2011 06:08:30 AM

If you can provide detail report that will be helpful.

Anh Posted Tue 09th of August, 2011 17:03:13 PM

The patient was brought to the operating room and after satisfactory general endotracheal anesthesia
had been obtained, the patient was placed prone on the Relton-Hall frame. In this position the back was
prepped and draped in routine and sterile fashion with Hibiclens soak, Hibiclens solution and ChloraPrep
twice. Fluoroscopy was used to identify the area overlying the facet joints at L4-5 on the left and
under fluoroscopic control we inserted a K wire down at the edge of the facet joint. We then inserted
the sleeve over the K wire and as we tried to insert the sleeve into the facet joint, the sleeve trapped
the K wire and advanced the K wire. This happened on 3 occasions. And finally, we avoided using the K
wires because we were concerned that these would get pushed into the spinal canal and instead we just
used the sleeve. Once the sleeve was docked in the edge of the facet joint, as was verified by
fluoroscopy, we then inserted the operating sleeve over the internal dilating sleeve, and we used a 5 mm
drill to drill the edge of the facet joint. A 5.5 mm milled bone plug was inserted along with 2 mL of
Trinity bone product. This was repeated again on the left of L5-S1 and then at the right side of L4-5
and then again on the right side of L5-S1. At the conclusion of the case, we could see the dowels having
been percutaneously inserted into the facet joints at L4-5 and L5-S1 bilaterally. We could also see the
Trinity bone product in the area behind the facet joints where the drilling had been performed. The
reamings produced from the facet joints demonstrated cartilaginous material. We sutured the stab
incisions with 3-0 Vicryl. Dermabond and Steri-Strips were then applied. Over this a sterile dressing.
The patient was carefully log rolled onto a gurney and taken to recovery in good condition where she was
seen to react satisfactorily following the anesthetic and moved both lower extremities without limitation or
difficulty. Estimated blood loss 10 mL.

SuperCoder Answered Wed 10th of August, 2011 17:06:06 PM

I am not sure, what do you say about 22558-22 and 22585; otherwise we can take 22899.

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