77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure)

Name of the Procedure:

Fluoroscopic Guidance for Needle Placement (e.g., biopsy, aspiration, injection, localization device)

Summary

Fluoroscopic guidance for needle placement is a procedure where a healthcare provider uses fluoroscopy, a type of real-time X-ray, to help accurately guide a needle to a specific location in the body. This technique is often used when performing biopsies, draining fluid, injecting medication, or placing a localization device.

Purpose

This procedure is used to address issues such as abnormal tissue that may need to be biopsied, fluids that require aspiration, localized pain requiring injections, or precise placement of devices. The goals are to ensure accurate needle placement, reduce the risk of complications, and improve the success rate of the primary procedure.

Indications

• Suspicious lesions or abnormal areas that need to be biopsied
• Collections of fluid that need aspiration
• Targeted delivery of medication through injections
• Placement of localization devices for surgery Criteria include a need for precise needle placement and situations where real-time imaging can significantly enhance procedural accuracy.

Preparation

• Patients may need to fast for a few hours before the procedure.
• Adjustments to medications may be required, particularly blood thinners.
• Pre-procedure imaging tests such as CT scans or MRIs might be needed to assess the target area.

Procedure Description

1. The patient is positioned on an examination table, typically lying down.
2. The target area is sterilized, and a local anesthetic may be administered to numb the site.
3. A fluoroscopic device is used to provide real-time imaging.
4. The healthcare provider inserts the needle, making adjustments as guided by the fluoroscopic images.
5. The necessary biopsy, aspiration, injection, or device placement is then carried out through the guided needle.

Duration

The procedure typically takes between 30 minutes to an hour, depending on complexity.

Setting

This procedure is usually performed in a hospital radiology department, an outpatient clinic, or a surgical center.

Personnel

• Radiologist or interventional specialist
• Nurses or medical assistants
• Possibly an anesthesiologist if sedation is required

Risks and Complications

• Common risks include mild bleeding or bruising at the needle site.
• Rare complications might involve infection, allergic reaction to contrast dye, or injury to nearby tissues.
• Management often includes observation, antibiotics for infections, and appropriate interventions for any tissue injury.

Benefits

The primary benefit is the precision and accuracy of needle placement, which reduces the risk of complications and improves the effectiveness of the primary procedure. Benefits are often realized immediately after procedure completion.

Recovery

• Patients may need to stay under observation for a short period for immediate post-procedure monitoring.
• Instructions may include resting the affected area and avoiding strenuous activities.
• Follow-up appointments may be scheduled to ensure no complications arise.

Alternatives

• Blind needle placement, which lacks the precision of fluoroscopic guidance and has higher risk.
• Ultrasound-guided needle placement, which may not provide as clear an image but avoids radiation exposure.
• Pros of alternatives can include reduced radiation exposure, while cons might involve lower accuracy or higher risk of complications.

Patient Experience

• Patients can expect to feel slight pressure or discomfort at the needle site.
• Pain management includes local anesthesia, and sedation can be administered if needed for patient comfort.
• Minimal post-procedural discomfort is typical, with most patients able to resume normal activities within a day or two.