using -59 modifier on pain block codes

nan.coder

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Saint Louis, Missouri
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Happy Halloween,

At our Ambulatory Surgery Center, in the pre-op are, the anesthesiologist performs a pain block (popliteal, ankle, interscalene, etc) to control post-op pain at the documented request of the Orthopedic Surgeon.

The literature that I'm finding on coding these pain block procedures, indicate that a -59 modifier should be appended to the pain block CPT code. I am hung up on the phrase "not ordinarily encountered or performed on the same day BY THE SAME INDIVIDUAL".

Can someone assist me in understanding why the -59 modifier can be used? Is it because "Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used"?

Thank you.

Nancy Boyle, CPC
St Louis Spine and Orthopedic Surgery Center
 

drakena74

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Local Chapter Officer
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Fullerton, CA
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The pain block needs to be administered by the Anesthesiologist in order for you to get paid. It also has to be documented separately from the Anes record. This is where the -59 mod comes in. If the pain block is admin by surgeon, it's bundled into primary code.
 
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