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Thread: Nerve block by surgeon

  1. #1

    Default Nerve block by surgeon

    AAPC: Back to School

    I'm new to ASC billing and I have a question. Is the ASC able to bill for a nerve block given as anesthesia by the surgeon?

    I'm billing for the surgery center. The surgeon did a plantar fascial release along with a tibial nerve block. Do I only bill the plantar release?

    Thank you in advance!

  2. #2


    (These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

    I would look for a second opinion about what I am going to tell you, but this is what we do:

    If it was for anesthesia, then the anesthesiologist bills. If it was for post-op pain, then the ASC bills (with a -59 modifier) even if administered by an anesthesiologist. Some carriers pay, some do not, but bill 'em all. You indicated that the block was performed by the surgeon, which would indicate to me that it was for post-op pain.

    Richard Mann, your pain management coder

  3. #3


    it's actually the first thing the surgeon does. He blocks the ankle and then procedes with the surgery.

    Is it possible to block the ankle before the surgery for purposes of post op pain?

  4. #4
    Join Date
    Apr 2007


    My understanding is that the ASC can bill for a nerve block if performed by the anesthesiologist and ordered by the surgeon for post op pain. Documentation should support this. You should use the acute post op pain diagnosis with the nerve block (338.18). You cannot bill for it if the surgeon did the block. Do not bill Medicare as they bundled it as of 01/01/10.

  5. #5


    thank you for the information.

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