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Wiki Code 64421 ONQ pump

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CECarroll

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Being denied for code 64421 with mod 59 as part of primary procedure?
 
It's my understanding that OnQ has a couple different types of pain management pumps. If it's the C-bloc, 64421 won't work because the C-bloc is a continuous peripheral nerve block. If code doesn't state "continuous infusion" it's not valid for that product so use the unlisted 64999. The payer might also be considering it part of the global surgical package that includes pain management, if done by the same surgeon that did the main procedure.

Good Luck!
 
Good article in this month's AAPC journal Coding Edge about this very topic.

In summary, most payers consider the On-Q pump part of the primary procedure, but check with each payor to determine.
 
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