What does the diagnosis paresthesias mean?
Procedure: Lumbar puncture
Indication: Paresthesias
Procedure:
Prior to the procedure, the relevant films were reviewed. Informed consent was obtained from the patient.
The patient was placed on the procedure table in prone position. The lower spine was examined with fluoroscopy. The area was then marked. The L3–L4 area was then prepped and draped in the usual fashion using chlorhexidine swab. Approximately 5 cc of 1 percent lidocaine was then used to anesthetize the area. A 20-gauge, 10 cm spinal needle was then advanced under direct fluoroscopic guidance into the thecal sac. The stylette was then removed, demonstrating adequate CSF backflow. Opening pressure was approximately 115 cm of water. Approximately 24 cc of fluid was removed without complication. Closing pressure was about 75 cm of water. Needle was then removed and bandage applied. 0.3 minutes of fluoroscopy time were utilized. The patient was instructed to lie in the horizontal position for at least 2 hours to decrease risk of spinal headache.
The diagnosis of paresthesia indicates that the patient has central or peripheral nervous system abnormalities. Typically the patient has feelings of pins and needles. A lumbar puncture may be necessary to eliminate a diagnosis of tertiary syphilis, carcinomatous meningitis, or central inflammatory cause.
CPT Code Assignment:
62270 Spinal puncture, lumbar, diagnostic
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