Ask Dr. Z

How would you code an injection of steroids into the cubital tunnel? Unlisted or 64450? "The medial epicondyle and left olecranon process is used to identify the nerve line in-between the structures just posterior to the medial epicondyle. Following the cubital tunnel the nerve is seen lying between the two heads of the flexor carpi ulnaris muscles and beneath the overlying capital to the retinaculum. The transducer is rotated, and the needle is placed through the skin above the lateral aspect of the ultrasound transducer and advanced using a plane approach until the needle tip reached the proper position the elbow. Images were printed to be scanned and saved. The ulnar nerve is identified. Color Doppler was used. Then a 1.5 inch, 25 gauge needle is advanced using and out of plane approach directly under tip in proximity to the ulnar nerve. After careful aspiration 10 mg of kenalog mixed with 1 cc of lidocaine 1% is injected slowly with minimal resistance to the left cubital tunnel and no paresthesia noted."