Wiki Billing Single Lumbar Plexus Blocks

[RPacheco]

Does anyone know the correct way to bill a 'single injection lumbar plexus block' for post op pain?
Recently had a few denials from Medicare with the '59/52' modifiers. Want to see if anyone else is having the same problem. Thanks.

 

[cbunti]

We are having the same problem but I do not know the solution.

 

[jdrueppel]

I need a little more information before I can respond.
Are you billing this for chronic pain OR postoperative pain management?
Are you billing any other services for this date?

Julie, CPC

 

[cbunti]

The injection is provided for post op pain management on the same day as the surgery.

 

[jdrueppel]

On the few occasions my docs have performed a single lumbar plexus block for postoperative pain management I've billed it as 64449-52 59 (reduced services / separately identifiable for postop pain).

Julie, CPC

 

[mitchellde]

are you linking this to a 338.xx code for acute post operative pain?

 

[tadavis]

yes I would use 3338.28--other chronic post-op pain

 

[jdrueppel]

If the purpose of the block is for postoperative pain management I would use dx code 338.18 and not a chronic pain dx code.

Julie, CPC

 

[TammyW]

I agree 338.18 as your primary diagnosis ~ with your surgery diagnosis secondary.
but I would also consider your mode of anesthesia as a possibility of your denial.
also, 64449 description says "continuous infusion"... I might would look at 64483.

Tammy, CPC, CANPC