I too bill for anesthesia. We have not been instructed to, nor do we bill the -51 modifier on any of the blocks. In addition, on those blocks that you do not bill the -59 modifier, they will deny as inclusive as you are not giving the payer any information to indicate that it's separately payable/not the mode of anesthesia.
Just curious, in this scenario you indicate continuous epidural, single sciatic and single femoral blocks all for postoperative pain management. That's alot of block! For example - if the patient has a continuous epidural they are numb below the waist -- why would they need the short acting femoral and sciatic blocks? Are you sure the continuous epidural --OR-- the femoral/sciatic blocks were not the mode of anesthesia and, therefore, not separately billable.
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