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Post Op Pain Block

  1. #11
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    I work for an ASC in California. The following are the pain blocks our anesthesiologist perform: 64413, 64415, 64445, 64447. We have also done a few of the pain pumps as well.

    The documentation on the Op report should state that the anesthesiologist performed a pain injections. on the anes. documentation it should stated that the surgeon requested the pain block. Make sure the pain block documentation is seperate from the procedure anes. record. If the surgeon peforms the block, you can't bill it seperately.

    In our billing system, if we bill on paperclaim, unfortunately it gets printed on different claims form from the procedure, but this was never a problem getting paid.

    we bill the above codes with modifier -59, -RT/-LT and with Dx 338.18. We've never had a problem with getting paid from any of our carriers including BCBS out of state plans. We don't bill Medicare because they don't pay. Wokers' Comp is wishy washy. sometimes they pay, sometimes they don't. We still bill to them anyway.

    As far as the 338.18 dx, i've gotten conflicting info on it. some say to bill 338.18 if injections given after procedure & 7xx.xx codes for before procedure. I've also heard we can bill 338.18 regardless of when injection was given. both info came from experienced coders.

    if you would like an example of how our anes. document the injections, just email me & I'll send a copy.

    jdewitte74@gmail.com
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

  2. #12
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    Do any of your payors reimburse the pain block as a multiple procedure? We have noticed that BCBS and UHC have now started to do this and wondering if this is acceptable or if we can appeal.

    Theresa Diers
    BJOSC, LLC

  3. #13
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    Quote Originally Posted by tdiers View Post
    Do any of your payors reimburse the pain block as a multiple procedure? We have noticed that BCBS and UHC have now started to do this and wondering if this is acceptable or if we can appeal.

    Theresa Diers
    BJOSC, LLC
    Sometimes they do, sometimes they don't. They can't seem to make up there minds how they want to pay it. :-) But most pay as a multiple procedure.

    In California, Anthem BC & Blue Shield are seperate entities. Per our BS contract they will only pay up to 2 lines.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

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