Wiki post operative nerve blocks

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CROBINSON1988

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The physicians I work for do nerve blocks after every surgery they complete. So i bill code 64450. Some insurance carriers pay right out and some deny right out. Can anyone give insight on this please?

Thanks,

Cynthia Robinson
 
What kind of surgeries are these and what is the purpose of the nerve block? Is it done after the surgery on the same date, or a subsequent date?

Most payers that follow CMS' NCCI and global surgery guidelines would not allow separate payment for this. Per the NCCI manual "with limited exceptions, Medicare does not allow separate payment for anesthesia services performed by the physician who also furnishes the medical or surgical service. In this case, payment for the anesthesia service is included in the payment for the medical or surgical procedure. For example, separate payment is not allowed for the physician’s performance of local, regional, or most other anesthesia including nerve blocks if the physician also performs the medical or surgical procedure." Post-surgical pain management by the surgeon is also considered a part of the global surgery payment and would not be separately allowed during the global period following surgery.
 
Hi Thomas,

Thank you for your insight. This service is performed on the same date of service as the surgery. They perform this to alleviate any pain the patient may have after the surgery. The physician's i work for do the following types of surgeries: Podiatry, Hand, and Decompression of nerves that cause migraine headaches.
 
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