My physician and I recently argued over billing a pudendal nerve block (64430) in addition to some of his anorectal cases, such as a Hemorrhoidectomy (46260). It passes NCI edits, however, my opinion is that since the purpose of the nerve block is to assist in post operative pain management, it is part of the global for 46260. My physician stated that most all anorectal cases include a nerve block, but it is not integral to the success of the procedure. Is anyone billing the nerve block?