Adductor Canal block/Saphenous Nerve Block

TAMMY12

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Anesthesiologist does Adductor Canal block for lower leg pain. Following day he does a saphenous block. Would you code 64450 for Adductor and 64447 for Saphenous?
 

dwaldman

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Per AMA CPT Assistant, they indicating to use 64447 for the adductor canal.
AMA CPT Assistant came out with the below in 2014.
November 2014 page 14

Frequently Asked Questions:Surgery: Nervous System

Question: What is the correct CPT code to report for adductor canal single shot injection for a pain block?

Answer:The adductor canal pain block for a single shot would be reported with code 64447, Injection, anesthetic agent; femoral nerve, single.

Question: What is the correct CPT code for adductor canal continuous catheter pain block?

Answer:Code 64448, Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement), would be reported when a continuous infusion is performed and a catheter is used.
 

sbslufkin

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76942 (x2) with 64447 & 64448

I have billed Medicare (Novitas) for CPT 64447 WITH 76942 (Ultra Sound Guidance) and CPT 64448 WITH 76942 for POST OP pain after a Total Knee Replacement.
Modifier 26 is added to CPT 76942 for both line items. Each procedure is reported as a separate line item.

98% of the time, both 76942 codes are denied and then submitted for reconsideration with the result being that only 1 pays and the other denies as a duplicate.
I have 2 images for the 2 sites, however, the provider does his dictation for both procedures on the same procedure note.

I am looking for advice on how to get the 76942 codes to pay for both without having to appeal.

Question: What is the correct way to bill TWO CPT codes 76942 (Ultra Sound Guidance) with 64447 (Adductor canal single shot injection for a pain block) and
64448 (Adductor canal continuous catheter pain block) when performed on a single patient?

Question: Do additional modifiers need to be submitted along with the modifier 26?
 

LisaAlonso23

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I have billed Medicare (Novitas) for CPT 64447 WITH 76942 (Ultra Sound Guidance) and CPT 64448 WITH 76942 for POST OP pain after a Total Knee Replacement.
Modifier 26 is added to CPT 76942 for both line items. Each procedure is reported as a separate line item.

98% of the time, both 76942 codes are denied and then submitted for reconsideration with the result being that only 1 pays and the other denies as a duplicate.
I have 2 images for the 2 sites, however, the provider does his dictation for both procedures on the same procedure note.

I am looking for advice on how to get the 76942 codes to pay for both without having to appeal.

Question: What is the correct way to bill TWO CPT codes 76942 (Ultra Sound Guidance) with 64447 (Adductor canal single shot injection for a pain block) and
64448 (Adductor canal continuous catheter pain block) when performed on a single patient?

Question: Do additional modifiers need to be submitted along with the modifier 26?

If your provider performs two nerve blocks using ultrasound (76942) for both, you would only bill 76942 once with a -26.
 
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