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Wiki Nerve block in ER with avulsion cleaning

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Jwags914

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I am wondering if you can provide any guidance on when it is appropriate to bill 64450 on the facility side. Here is what I am working with and another coder and I disagree on if it should be billed separately or if it is considered part of the E&M and not separately billable.

A digital block was preformed at the base of the R 4th digit (ring finger). Wound was cleaned well with clorihexidine soap and moderate pressurized saline flush. Wound was prepped with bacitracin and xeroform gauze and a tube gauze dressing applied.
tetanus is UTD.
 
Dig Block

I would code the peripheral nerve block, as it was not part of a procedure, but appears to be by your scenario given to alleviate pain for cleansing of the wound.
 
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