20700 Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure)

Name of the Procedure:

Manual Preparation and Insertion of Drug-Delivery Device(s), Deep (Subfascial)

Summary

This procedure involves the manual preparation and insertion of a drug-delivery device into a deep tissue layer, such as beneath the fascia (a band of connective tissue surrounding muscles). It is an adjunctive procedure often done in conjunction with a primary surgery or treatment to deliver medications directly to the targeted area.

Purpose

• Addresses specific medical conditions requiring localized drug delivery.
• Aims to provide targeted treatment, reduce systemic side effects, and improve medication efficacy.

Indications

• Chronic pain management
• Localized infections needing antibiotic delivery
• Cancer treatments needing localized chemotherapy
• Other conditions requiring direct medication to deep tissues

Preparation

• Follow fasting instructions as directed by the healthcare provider.
• Adjust medications if instructed.
• Undergo any required diagnostic tests such as blood tests, imaging studies, or allergy screenings.

Procedure Description

1. Patient is prepped and positioned appropriately.
2. Local or regional anesthesia is administered to numb the area.
3. The surgical site is cleaned and sterilized.
4. A small incision is made to access the deep tissue.
5. The drug-delivery device is manually prepared and inserted into the targeted deep tissue layer.
6. The incision is closed using sutures or surgical staples.
7. The area is dressed with a sterile bandage.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the complexity and site of insertion.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeons
• Anesthesiologists
• Nurses
• Surgical Technicians

Risks and Complications

• Infection at the insertion site
• Bleeding or hematoma formation
• Device malfunction or displacement
• Allergic reactions to anesthesia or materials
• Nerve damage or deep tissue injury

Benefits

• Targeted and efficient drug delivery
• Reduced systemic side effects
• Potentially quicker onset of medication effects
• Enhanced control of local symptoms

Recovery

• Keep the incision site clean and dry.
• Follow weight-bearing and activity restrictions as advised.
• Take prescribed pain relief medications as needed.
• Attend follow-up appointments for wound check and device adjustment.
• Full recovery may vary from a few days to a couple of weeks, depending on the individual case.

Alternatives

• Oral or systemic drug delivery methods
• Topical medication application
• Intravenous drug administration
• Each alternative has its pros and cons in timing of effect, side effects, and overall effectiveness.

Patient Experience

• The patient might feel some pressure or pulling during the procedure but should not feel pain due to anesthesia.
• Mild to moderate postoperative pain and discomfort at the incision site.
• Pain management includes prescribed oral medications and supportive measures like cold compresses.
• Bruising and swelling around the incision site are common but typically resolve within a few days.