jeudi 19 février 2015

Dye study for pain pump catheter placement - help!

How would you code from the following? We are going round in circles and cannot come up with anything that describes it well. Help?!

History:This is a pleasant but unfortunate gentleman with a spinal cord injury and severe spasticity. The patient has an intrathecal baclofen pump, but has increasing spasms despite accelerating dosages of his intrathecal pump. We were called from the ER earlier this week and they were concerned about catheter malfunction. We have discussed with the patient and family the dye study utilizing catheter access port under fluoroscopic guidance and we discussed the potential need for re-programming after.


Procedure: Intravenous access and monitors were applied. Procedure was discussed with patient. Questions were answered and consent was obtained. The patient was brought to the OR, placed supine, and sterile prep and drape done of the pump site using the template and live fluoroscopic guidance and the catheter access port was identified and it was instrumented after 2 attempts. Fluid/CSF 1.5mL was withdrawn from the catheter. The catheter was then injected with radiopaque contrast material. The catheter was traced into the spine. The patient was supine and the dye was spread posterior. There was concern of an epidural catheter placement. The myleogram was somewhat consistent with an epidurogram versus myleogram. At this point, the needle was removed. The patient's injection site was bandaged. He was taken to the recovery area. Vital signs were monitored and he was discharged to have a CT to determine intrathecal versus epidural dye spread. The patient was then sent to the office for reprogramming.






Dye study for pain pump catheter placement - help!

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