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Clarification Needed - Digital Nerve Blocks

  1. #1
    Default Clarification Needed - Digital Nerve Blocks
    Medical Coding Books
    Can someone clarify how to bill this? Is it 6 units?


    RIGHT HAND/DIGIT NB



    ANESTHESIA: Local

    PREOPERATIVE DIAGNOSIS: Digital neuropathy post traumatic amputation of the second third and fourth digits on the right hand.
    POST-OPERATIVE DIAGNOSIS: Same

    INDICATIONS: Pain in the digits of the right hand

    DESCRIPTION OF PROCEDURE: After written informed consent was obtained from the patient and benefits and risks discussed including but not limited to: Benefits being pain relief. Risks being infection bone nerve damage intravascular injection causing infarct of soft tissue.

    The patient is brought to the procedure room and is seated on one of the chairs. His right hand is placed on the procedure room table, and it is prepped with Betadine in sterile fashion. Injection is performed on either side of the each of the digits stumps utilizing a half cc on each side of a mixture of 6 mg of betamethasone and 3 cc of 0.25% Marcaine. Needle removed puncture wounds were dressed patient tolerated the procedure well.

    Any help is greatly appreciated!

    Melissa Harris, CPC
    The Albany and Saratoga Centers for Pain Management

  2. #2
    Default
    In this situation, the CPT code would be 64450. NCCI guidelines state as well as MUE edits that only 1 injection per digit per day. Therefore this would be 3 units not 6.

    Hope this helps
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  3. #3
    Default
    Thank you! That was what I was thinking but the physician stated six.
    Melissa Harris, CPC

  4. #4
    Smile
    Anytime!!! Glad I could help
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

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