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Wiki Can I charge 64425 done by an anesthesiologist?

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Okmulgee, OK
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I work for a tribal system. We bill for the provider, facility and anesthesiologist.

My question is, can I bill 64425 done by anesthesiologist? The anesthesiologist is documenting that the procedure is done by him for post operative pain management.

Per Medicare Article A57452:
FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES statesPostoperative pain management services are generally provided by the surgeon who is reimbursed under a global payment policy related to the procedure and shall not be reported by the anesthesia practitioner unless separate, medically necessary services are required that cannot be rendered by the surgeon. The surgeon is responsible to document in the medical record the reason care is being referred to the anesthesia practitioner.” Thus any such additional nerve blocks must not only be properly documented for why they cannot be rendered by the surgeon, but also would be quite rare.
 
I work for a tribal system. We bill for the provider, facility and anesthesiologist.

My question is, can I bill 64425 done by anesthesiologist? The anesthesiologist is documenting that the procedure is done by him for post operative pain management.

Per Medicare Article A57452:
FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES statesPostoperative pain management services are generally provided by the surgeon who is reimbursed under a global payment policy related to the procedure and shall not be reported by the anesthesia practitioner unless separate, medically necessary services are required that cannot be rendered by the surgeon. The surgeon is responsible to document in the medical record the reason care is being referred to the anesthesia practitioner.” Thus any such additional nerve blocks must not only be properly documented for why they cannot be rendered by the surgeon, but also would be quite rare.
Yes, and the block needs 59 modifier and laterality modifiers. The block note needs to indicate the block was requested by the surgeon, as surgeons usually perform this service. The diagnosis for the block should be G89.18. Please see page 495 in the 2025 CPT manual for a chart that indicates when ultrasound is separately billable.
 
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