4th Qtr 2016 ISAAC MSK Nursing Case Study #1
CIGNA Commercial
Req for 64483 x 1 and 64484 x 1 (Bilateral L5-S1)
No prior injections.
Pt c/o LBP x 2015. Pain is rated 7/10, pain radiates into posterior thigh, calf, and to bottom of foot. Described as aching, throbbing, and numbness.
Pt has failed treatment with Medrol dose pack and chiro. Currently taking Motrin. Pt is scheduled for PT following injection.
PE: 11-15-2016: + SLR. Decreased sensation RLE
6/21/16 MRI L spine: L4-5 disc herniation with lateral recess stenosis and encroachment- compromise of descending nerve roots. L5-S1 disc herniation with severe spinal stenosis.
MD planning therapeutic Bilateral L5-S1 TF ESI
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