Thoracic Surgery help

Pam Brooks

True Blue
Local Chapter Officer
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I am hoping to get some thoracic surgery advice from coders out there who are willing to share their expertise.

I have several questions, but will post them individually. I'm an E&M specialist who has been tasked with some interim coding for a thoracic surgeron. :confused: Here's one example:

The surgeon wants to bill for a Intercostal nerve block, which he performs himself, separate from anesthesia services This is usually done when additionally performing a thoracotomy. I've not been billing them (because he doesn't document the procedure), however when I meet with him again, I wanted to discuss whether or not we actually could bill it as a separate procedure, provided he documents. Can he bill for this?

Thanks in advance! Pam Brooks, PCS, CPC
 

IHAVELKA

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Pam-
According to the Medicare carriers manual, nerve blocks are part of the comprehensive procedure and it is inappropriate to bill together...hope this helps.
 

Pam Brooks

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Local Chapter Officer
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thoracic surgery help

Thanks, I was concerned that I was missing something. I'll print the reference from CMS, so I can provide the doc with the education. Have a good week. Pam
 

aguelfi

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I don't agree

Pam, I've posted them in the past using 64420 and I get audited every quarter by company and have never had a problem. However, I did requiree to document it. If it wasn't documented in the body of the op-note, I didn't bill for it. It may be bundled w/ certain procedures so you will need to check your cci w/ each procedure.
 

jennsomers

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If its documented- I bill for it. I have been getting paid for it with a mod 59 and a dx of neuritis/neuralgia etc.
 
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