In Office Procedures?


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HELP! :confused:

I have an ortho in Oklahoma who is going to start doing in-office minor procedures. They are trying to decide whether to have the ortho administer nerve blocks, Versed, etc., or have a CRNA come to the office to do it so that they don't have the responsibility of maintaining a drug supply in their office. My hunch tells me that if the ortho administers any of these, it will be considered inclusive to my surgical CPT code.

Say he does a wrist ganglion excision in the office, I am going to bill CPT 25111 for him. If a CRNA is present and performs a block for this procedure, is that separately billable and payable? Would it affect payment if the CRNA is a stand-alone provider versus an employee of the practice?

These would all be POS 11...just trying to figure out what is billable and what is not. I am not even sure if I am asking the right questions.

Any assistance would be greatly appreciated!


Kara Hawes, CPC


True Blue
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Just would want to check your contracts they cover minor ortho procedures in an office setting. I believe the CRNA would be separately reimbursed. But can't say for certain. Whatever would be the best interest of the patient in regards to the physician performing it versus CRNA----safety and cost effectiveness. The physician could potentially be reimbursed with the moderate sedation codes such as 99144/99145. Could check the moderation sedation which are included in the appendix for the procedures he planning to do.