Wiki Superficial cervical plexus block

[jastewart]

I have a provider who wants to be paid separately for a Superficial Cervical Plexus block performed at the same time as an Interscalene block. Blocks are performed prior to shoulder arthroscopy. From what I understand when a large volume of local anesthetic is used for an interscalene brachial plexus block the cervical plexus is also anesthetized. Additionally the documentation does not support that a separate block was performed. Am I correct that this is not separately payable?
This is the documentation:
Position: Supine; Side: Left; Blocks Interscalene, Superficial Cervical Plexus 5 ml/ Ultrasound; Sedation: (Propofol 100mg); Bupivacaine; %: 0.38; Plain; Volume (ml): 15; No Paresthesia; Sterile Prepped with Chlorohexidine; Per Surgeon Request; Catheter: Single Shot

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[LisaAlonso23]

What is the primary anesthetic use? If it's MAC, the blocks are not separately billable.

If it's General, you would need documentation stating the blocks were performed for post-op pain management.

 

[jastewart]

The blocks are for post-op pain management which is documented in the record. Are both blocks separately payable or would they be paid as one as there is no documentation they were performed separately?

 

[LisaAlonso23]

The blocks are for post-op pain management which is documented in the record. Are both blocks separately payable or would they be paid as one as there is no documentation they were performed separately?

Are you saying there aren't block notes? You need separate notes describing ancillary procedures (ie, blocks, lines, etc) and why they were performed in order to code/bill them.

 

[jastewart]

Are you saying there aren't block notes? You need separate notes describing ancillary procedures (ie, blocks, lines, etc) and why they were performed in order to code/bill them.

the provider documented why blocks were performed and documentation does support separate coding for the interscalene block but I don't believe the documentation supports separate payment for a cervical plexus block in addition to the interscalene block.
This is the only documentation in the record that refers to the blocks being performed:
Position: Supine; Side: Left; Blocks Interscalene, Superficial Cervical Plexus 5 ml/ Ultrasound; Sedation: (Propofol 100mg); Bupivacaine; %: 0.38; Plain; Volume (ml): 15; No Paresthesia; Sterile Prepped with Chlorohexidine; Per Surgeon Request; Catheter: Single Shot

 

[jodielonkoski]

Superficial cervical plexus is separate from interscalene for post op pain, I code anesthesia and we use these 2 frequently for post op pain, 64999 for the cervical plexus and you can bill for the ultrasound, if used, as it is not included in the unlisted code

 

[LisaAlonso23]

the provider documented why blocks were performed and documentation does support separate coding for the interscalene block but I don't believe the documentation supports separate payment for a cervical plexus block in addition to the interscalene block.
This is the only documentation in the record that refers to the blocks being performed:
Position: Supine; Side: Left; Blocks Interscalene, Superficial Cervical Plexus 5 ml/ Ultrasound; Sedation: (Propofol 100mg); Bupivacaine; %: 0.38; Plain; Volume (ml): 15; No Paresthesia; Sterile Prepped with Chlorohexidine; Per Surgeon Request; Catheter: Single Shot

I don't see where the documentation states the reason for the cervical plexus block. You need that information in order to code/submit it.