nerve block coding ASC -denials Blue Cross

[csorensen21@yahoo.com]

I work at an ASC in Michigan and we bill nerve blocks for post operative pain management. We are receiving denials for bundling issues (with or without a modifier 59) on our nerve block codes (64445,64448,64473). Is anyone else experiencing similar issues? We were getting paid and now we are not. Now Blue Cross is paying sporadically and our appeals are getting denied upholding bundling. We are asking if there maybe a coding issue that we are not seeing?

example:
27447 RT
64448 59 RT
64445 59 RT

Thanks,

 

[jodielonkoski]

a post op pain block is not separately reportable if done by the surgeon.

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60295&ver=3

https://www.kzanow.com/coding-coaches/postoperative-pain-block-by-surgeon-05-22-25

 

[csorensen21@yahoo.com]

a post op pain block is not separately reportable if done by the surgeon.

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60295&ver=3

https://www.kzanow.com/coding-coaches/postoperative-pain-block-by-surgeon-05-22-25[/URL

These are not Medicare claims. These are Blue Cross commercial. We get paid on 85% of these claims for the blocks and 15% denial rate. I am aware of the CMS guidelines.[/url]

 

[LisaAlonso23]

Nerve blocks performed by surgeons are bundled and not separately reportable.