Wiki Nerve Blocks at ASC

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katz0813

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I am billing nerve blocks at an ASC. My question is... do I also bill the PROFEE side with the nerve blocks or just the product injected. As an example, 64450 with J1020. I believe I should only bill J1020 on the PROFEE side and 64450 at the ASC only. I would think billing 64450 on the PROFEE side would be double dipping. Thanks!
 
katz0813 said:
I am billing nerve blocks at an ASC. My question is... do I also bill the PROFEE side with the nerve blocks or just the product injected. As an example, 64450 with J1020. I believe I should only bill J1020 on the PROFEE side and 64450 at the ASC only. I would think billing 64450 on the PROFEE side would be double dipping. Thanks!
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Good question. We do not report any medications given in the ASC unless it is exparel. So, I only code 64450 for both claims. It is not double dipping because the profee side is being reimbursed for the professionals whereas the facility is reimbursing for the services/supplies/equipment performed at the facility.
 
I really appreciate your response! Not familiar with all the nuances of the ASC. This is a Spine doc now giving injections in the OR at our ASC. So, 64450 for PROFEE and ASC - Thanks you! What about J1020 (methylprednisolone acetate)? If I am understanding you correctly, it is not billed at all on either side? When these were performed in an office setting 64450 and J1020 was billed.
 
Yes, you are correct that the 64450 is reported on both claims and the J1020 is not reported at all. Let me know if you need help if it was done bilaterally and unsure how to report the modifiers for each claim or any other questions you may have.
 
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