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Thread: Modifiers for bilateral nerve blocks

  1. #1
    Join Date
    Apr 2007

    Default Modifiers for bilateral nerve blocks

    AAPC: Back to School
    I am in Anesthesia billing and need some guidance on determining the appropriate modifers to bilateral knee blocks -- Scenerio --

    Procedure was bilateral knee replacement.

    Along with the general anesthesia, bilateral blocks were placed as well.
    For the coding of the blilateral blocks -

    Would be coding for the blocks be -
    64445-59 - for the first nerve block
    64445-59-50-51 - for the second nerve block?
    ..or, does the -50 apply to the first block as well?

    Is there any documentation to clearly support the determination of the applicable modifiers in this scenario? Thanks for any and all suggestions.

  2. #2


    Is your provider doing sciatic nerve blocks? If so I would code it as follows:

    64445-59-LT and 64445-59-RT

    depending on the carrier. MC in my region prefers the 50 mod to left and right. If you are billing the 50 mod you should only bill one line item and double your billed amount. I believe MC pays these at 150%. If your provider is doing a femoral nerve block use 64447 with the same modifiers.
    Hope this helps.

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