Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Fluoroscopic Guidance and Localization of Needle or Catheter Tip for Spine or Paraspinous Diagnostic or Therapeutic Injection Procedures (Epidural or Subarachnoid)
Summary
This procedure involves using live X-ray imaging (fluoroscopy) to accurately guide a needle or catheter to a specific location in the spine or paraspinous area. It is typically part of diagnostic or therapeutic injection procedures, such as epidural or subarachnoid injections.
Purpose
This procedure is used to alleviate pain and inflammation in the spine or to diagnose issues within the spinal canal. It increases the accuracy of needle or catheter placement, ensuring the medication is delivered precisely where needed.
Indications
- Chronic back pain
- Sciatica
- Spinal stenosis
- Herniated discs
- Diagnostic purposes to identify the source of spinal pain
Preparation
- Patients may need to fast for a few hours before the procedure.
- Medication adjustments, such as stopping blood thinners.
- Diagnostic tests like MRI or CT scans may be required to pinpoint the problem area.
Procedure Description
- The patient lies on an X-ray table.
- The area of interest is sterilized, and a local anesthetic is applied.
- A fluoroscope provides real-time imaging to guide the needle or catheter.
- The physician inserts the needle or catheter and advances it to the targeted area.
- Once in place, a contrast dye may be injected to confirm proper placement.
- Medication, such as steroids or anesthetics, is administered through the needle or catheter.
- The needle or catheter is then carefully removed, and the puncture site is dressed.
Duration
The procedure typically takes 30 to 60 minutes.
Setting
It is performed in a hospital, outpatient clinic, or surgical center equipped with fluoroscopic imaging technology.
Personnel
- Interventional radiologist or anesthesiologist
- Radiologic technologist
- Nurse
- Sometimes an anesthesiologist for sedation management
Risks and Complications
- Infection at the injection site
- Bleeding
- Nerve injury
- Allergic reactions to the contrast dye
- Temporary increase in pain
Benefits
- Improved diagnostic accuracy
- Targeted pain relief
- Reduced inflammation
- Minimal invasiveness compared to surgical interventions
- Faster recovery compared to more invasive procedures
Recovery
- Patients may need to rest for a short period post-procedure.
- Instructions may include avoiding strenuous activities for 24-48 hours.
- Follow-up appointments to monitor the effectiveness of the treatment.
Alternatives
- Oral or injectable pain medications
- Physical therapy
- Surgery for more severe conditions
- Radiofrequency ablation
Patient Experience
- Mild discomfort during needle insertion.
- Local anesthetic minimizes pain during the procedure.
- Some soreness at the injection site afterward.
- Pain relief can be immediate or gradual over several days.
- Pain management includes prescribed painkillers or ice packs as needed.