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Billing Single Lumbar Plexus Blocks

  1. Smile Billing Single Lumbar Plexus Blocks
    Medical Coding Books
    Does anyone know the correct way to bill a 'single injection lumbar plexus block' for post op pain?
    Recently had a few denials from Medicare with the '59/52' modifiers. Want to see if anyone else is having the same problem. Thanks.

  2. #2
    We are having the same problem but I do not know the solution.

  3. #3
    I need a little more information before I can respond.
    Are you billing this for chronic pain OR postoperative pain management?
    Are you billing any other services for this date?

    Julie, CPC

  4. #4
    The injection is provided for post op pain management on the same day as the surgery.

  5. #5
    On the few occasions my docs have performed a single lumbar plexus block for postoperative pain management I've billed it as 64449-52 59 (reduced services / separately identifiable for postop pain).

    Julie, CPC

  6. #6
    Columbia, MO
    are you linking this to a 338.xx code for acute post operative pain?

  7. Smile
    yes I would use 3338.28--other chronic post-op pain

  8. #8
    If the purpose of the block is for postoperative pain management I would use dx code 338.18 and not a chronic pain dx code.

    Julie, CPC

  9. #9
    I agree 338.18 as your primary diagnosis ~ with your surgery diagnosis secondary.
    but I would also consider your mode of anesthesia as a possibility of your denial.
    also, 64449 description says "continuous infusion"... I might would look at 64483.

    Tammy, CPC, CANPC

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