Wiki How many units when billing post op blocks?

[meganrveach]

Can anyone tell me when billing for anesthesia and post op pain management blocks during same dos (all post op pain management blocks guidlelines have been met to warrant billing both) how many units do you place on the nerve block? We are contracted with Medicare.
Thanks for your help in advance!

 

[dwaldman]

For the block, I would bill the amount set up in your chargemaster as the same as a stand alone procedure, I would assume the Medicare carrier would also want minutes in the units field only with no base units for the anesthesia codes. I hope I am understanding the question correctly.

 

[meganrveach]

Thanks for your reply, I may not have explained too well. We are billing the anesthesia code (for this case) 00840 with 17 units (base + time) and we are billing the nerve block code 64450 with a 59 mod. My question is do we just bill one unit for the nerve block or do we use the 5 base unit value that the RV guide states? Thanks for your help!

 

[dwaldman]

"Actual anesthesia time in minutes is reported on the claim. For anesthesia services furnished on or after January 1, 1994, the A/B MAC computes time units by dividing reported anesthesia time by 15 minutes. Round the time unit to one decimal place. The A/B MAC does not recognize time units for CPT codes 01995 or 01996."

page 123 Claims Processing Manual Chapter 12

http://www.cms.gov/manuals/downloads/clm104c12.pdf

The way I understand when billing Medicare, you place the total minutes in the units field. The anesthesia formula of dividing the total minutes by 15 and adding the base units x the coversion factor is done on their end to calculate the reimbursement. In order for the carrier to process a correct payment they need only the total minutes. For post op blocks they are based on fee schedule amount that they are going to pay they are not going use time+base....

 

[jdrueppel]

Megan,

The block is actually a "surgical" service and would be billed as "1" unit because your provider performed this service x1. Anesthesia guidelines (i.e. base units) are specific to anesthesia services only.

Julie D