Wiki ASC billing for post op pain block

[cherylbr]

Anyone do billing for an ASC that can answer this question:

Is it appropriate to bill a facility charge for the post op pain block provided by the anesthesiologist during an orthopedic procedure done by an orthopedic surgeon?

Is this a reimbursed item by all insurance carriers?

What documentation is required?

Where might I find information regarding this?

Thank you,
Cherylbr

 

[nsteinhauser]

Hi Cheryl,
There are certain requirements that have to be met (i.e., there has to be a separate consent signed for the block, the Anesthesiologist has to separately dictate the 'op note' for administering the block, it has to be requested by the surgeon for post op pain, it helps if the surgeon also dictates in his/her op note that they requested the block for post op pain management, it has to be separate from and not the only anesthetic given for the case, etc.) but even if ALL of the requirements ARE met, some payers won't reimburse separately, even after appeal. So it depends on the payer even if you meet all of the requirements.
Attached is a post op pain article last updated 2015.
Hope this helps.

 

[cherylbr]

Hi Cheryl,
There are certain requirements that have to be met (i.e., there has to be a separate consent signed for the block, the Anesthesiologist has to separately dictate the 'op note' for administering the block, it has to be requested by the surgeon for post op pain, it helps if the surgeon also dictates in his/her op note that they requested the block for post op pain management, it has to be separate from and not the only anesthetic given for the case, etc.) but even if ALL of the requirements ARE met, some payers won't reimburse separately, even after appeal. So it depends on the payer even if you meet all of the requirements.
Attached is a post op pain article last updated 2015.
Hope this helps.

Thank you for your response. I am still confused. I did review that document and interrupt it as for the billing for the provider. I am billing for the ASC and wonder if it acceptable and payable for billing the block along with the anesthesia for the facility. Here is my example:
01400
64447 59
76942
again this is for the facility, not the provider (anesthesiologist)

Thank you again!