Wiki POPM by CRNA in MA


Waconia, MN
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Good Afternoon,
I am hoping that someone will have some information that may help me with this. I have a Blue Cross of Massachusetts patient that had an interscalene block done for post-op pain by the CRNA on the case. (The CRNA, who was non-medically directed, also performed the anesthesia for the surgery) I have gotten a denial from Blue Cross stating that the provider is not eligible to perform the service billed.
Is there anyone out that that can shed some light on this for the state of Massachusetts specifically BCBS as I haven't been able to find anything. I did see that in MA that a CRNA is considered an ARNP and that generally gives more leeway in the procedures that can be performed, but I didn't see anything in the Board of Nursing documents that specifically states they can or can't perform these procedures.

Once again - Thanks for the Help!

Hi Missy-

I have never billed POPM for a CRNA or AA-only the anesthesiologist. I believe this may be out of their scope of practice, especially with BCBS. But I am in Mississippi, not MA, so it could be different down here. Don't know if this helps or not! :confused:

Try this: use Yahoo Search, type in 'CRNA and post operative pain block'. There is a PDF about third down, from the ASA. On page 5, section 4.2, it says that a CRNA can bill for the post op pain block. So I think it's a BCBS thing that they don't allow the CRNA to bill for that.
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