Anesthesia Coding Alert

Question: How should I code a digital block of the fingers and toes? Is it appropriate to use a procedure code with modifier -47 (Anesthesia by surgeon) instead of an anesthesia code?

New Mexico Subscriber

Answer: You should report 64450* (Injection, anesthetic agent; other peripheral nerve or branch) if the physician uses the block for pain management or for postoperative pain control. Using anesthesia during a digital block is rare, so CPT/American Society of Anesthesiologists anesthesia codes would not usually be appropriate. If you are coding for anesthesia delivery separate from the block, however, report either 01810 (Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand) or 01470 (Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified) with modifier -23 (Unusual anesthesia) and supply documentation supporting medical necessity for the anesthesia.

You Be the Coder and Reader Questions were provided by Barbara Johnson, CPC, MPC, coder with Loma Linda University Anesthesiology Medical Group Inc. in Loma Linda, Calif.