Ask Dr. Z

I have never seen gold seeds used for localization of a lesion before surgery. There was increased activity in the paraspinous tissue L1 area on a PET/CT scan.. The patient's mid back is prepped and draped in a sterile manner. Under CT guidance a 18 gauge needle was advanced into the area of interest to the left of the L1 vertebral body. Two gold seeds were placed 0.8 mm x 5mm. The seeds were placed lateral to the left fusion rod and medial to the left 12th rib in the area of increased activity. The patient will have a PET CT scan to identify the relationship of the gold seeds to the area of increased activity. "Impression: Status post CT-guided placement of localization gold seeds." I was thinking of using code 77012 for the guidance and an unlisted code for the gold seeds... not sure of the correct unlisted code 20999 (musculoskeletal) or 22899 (spine). What would you suggest?