1.Right L4 Medial Branch, L5 Dorsal Ramus Branch, S1 Sacral Lateral Branch Block

Anesthesia:
Local with Moderate Sedation

Details of Procedure:
After obtaining informed consent the patient was positioned in prone position on a padded fluoroscopy table. The region of interest was prepped and draped in the usual sterile fashion. 1% lidocaine was used to anesthetize the skin over each target site.

Under fluoroscopic guidance, a 25g 3.5 inch spinal needle was advanced to the location of the medial branches of the right L4 nerves (at the intersection of the superior articular process and the transverse process of the associated vertebral levels). A 25 gauge 3.5 inch spinal needle was guided to the location of the right L5 dorsal ramus at the intersection of the superior articular process of S1 and the sacral ala.

The right S1 sacral lateral branches were blocked at the lateral aspect of the right S1 foramen with a 25 gauge 3.5 inch spinal needle.

*** One provider said to code 64493-RT, 64494-RT. The other to just code one level, 64493-RT.

Thank you in advance!:)