Wiki ASC Facility with post op pain block

[tuzzi]

Hoping someone will be able to help me out with this. I am coding and billing for the ASC facility side. And have a question as to reporting the post op pain block. For example:

Anesthesia documents post-op pain management at surgeons request. Block performed is right side brachial plexus. I am reporting with G89.18 with 64415-XP-RT.

I am receiving denials back from Medicare CMS for C0236 This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements.

Would I be better off filing 64415-59-RT along with CPT 29827-RT? I thought using the XP modifier would show a different provider (anesthesia) than the surgeon.

Thank you for your time!

 

[LisaAlonso23]

While some insurance accepts other modifiers for post-op pain blocks, I have had success with 59 on nerve blocks.

29827/01630
64415-59,RT G89.18

 

[missyah20]

I would agree with Lisa. If the anesthesia provider is performing the block it will bundle into the anesthesia code billed and if the same provider is on the 0xxxx charge and the block charge the XP wouldn't apply. We generally stick with the 59 modifier for our postop pain blocks.