Which level to do thoracic MBB at for scoliosis?

[CarabinerSD]

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I have a middle age patient with severe right sided thoracic pain from scoliosis. MRI T-spine with severe 18° right convex scoliosis at T6-T7, multiple levels of disc osteophyte complex from T5-6 to T8-9 that is fairly small 1-2 mm without any central or foraminal stenosis. Did not improve w/ TPI, erector spinae block, NSAIDs, the usual conservative care. Does not want spine surgery. Consider a thoracic MBB, wondering if T5-T7 block would be most helpful here.

 

[Agast]

Mark the area that hurts the most and confirm the final area under fluoro. I consent for my best guess and “other indicated level”

 

[asdfjklmed]

I have a middle age patient with severe right sided thoracic pain from scoliosis. MRI T-spine with severe 18° right convex scoliosis at T6-T7, multiple levels of disc osteophyte complex from T5-6 to T8-9 that is fairly small 1-2 mm without any central or foraminal stenosis. Did not improve w/ TPI, erector spinae block, NSAIDs, the usual conservative care. Does not want spine surgery. Consider a thoracic MBB, wondering if T5-T7 block would be most helpful here.

How did you bill the erector spinae block

 

[Taus]

Mark the area that hurts the most and confirm the final area under fluoro. I consent for my best guess and “other indicated level”

This. Exam under fluoro. Mark tender levels. Inject joints below. Count levels after.

 

[CarabinerSD]

Mark the area that hurts the most and confirm the final area under fluoro. I consent for my best guess and “other indicated level”

Thanks for the advice!

 

[CarabinerSD]

How did you bill the erector spinae block

As of current coding guidelines, an erector spinae block is typically coded as CPT 64999 which represents an "Unlisted procedure, nervous system" because there is no specific code for this fascial plane block.

That's what my biller told me...

 

[Quixotic2501]

New codes for ESP block: Look to New Plane Block Code for 2025 : Orthopedic Coding

 

[RoloTomassi]

New codes for ESP block: Look to New Plane Block Code for 2025 : Orthopedic Coding

Thanks! Lumbar ESP would've been nice