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interscalene block

  1. #1
    Medical Coding Books
    If the block was placed for post op pain relief, it can be billed with a modifier 59. Time should not be included in the procedural time.

  2. #2
    It should be documented on the anesthesia report if it was done for post op pain relief. I believe it can be done either before or after the procedure.

  3. Default code for scalene?
    What is the code for that?

  4. Default CPT ASST Article
    Year: 2001

    Issue: October

    Pages: 9

    Title: Anesthesia and Postoperative Pain Management

    Body: Coding Clarification

    The following article builds on information originally presented in the February 1997 CPT Assistant article, "Anesthesia: Coding for Procedural Services."

    Codes for procedures commonly used in the management of postoperative pain include 62318 and 62319 (both introduced in CPT 2000) for continuous epidural analgesia and the series of codes for somatic nerve blocks (64400-64450).

    It is appropriate to report pain management procedures, including the insertion of an epidural catheter or the performance of a nerve block, for postoperative analgesia separately from the administration of a general anesthetic.

    When general anesthesia is administered and these injections are performed to provide postoperative analgesia, they are separate and distinct services and are reported in addition to the anesthesia code. Whether the block procedure (insertion of catheter; injection of narcotic or local anesthetic agent) occurs preoperatively, postoperatively, or during the procedure is immaterial.

    If, on the other hand, the block procedure is used primarily for the anesthesia itself, the service should be reported using the anesthesia code alone. In a combined epidural/general anesthetic, the block cannot be reported separately.


    • A patient having total knee replacement surgery may receive a regional anesthetic and a postoperative pain management agent through the same epidural catheter, in which case the only code reported would be 01402.

    • A femoral nerve block (64450) placed to provide post-operative analgesia for an anterior cruciate ligament repair or a total knee replacement would be reported separately from the surgical anesthesia.

    • A patient undergoing a thoracotomy might receive an epidural injection of a local anesthetic and/or narcotic (62318) for postoperative pain control in addition to the general anesthetic, which is administered through an endotracheal tube (00540). In this case, the epidural is not the surgical anesthetic and it would be reported separately, as an independent procedure.

    • Shoulder surgery could be performed under an interscalene brachial plexus block that would also provide postoperative analgesia. This would be reported using the anesthetic code (eg, 01620). If the block were intended primarily to alleviate postsurgical pain, and a general anesthetic was administered for the shoulder procedure, the block would be separately reportable using code 64415.

    • A brachial plexus block might also provide both the anesthesia and the postoperative pain control for an open reduction of a wrist fracture. Only the anesthesia code would be reported.

  5. #5
    Default Comprehensive reference from the ASA
    I am unable to upload the the only way to access this document is to google.......Reporting Postoperative Pain Procedures in Conjunction with Anesthesia and the first hit should be a pdf from the ASA.
    Good luck!

  6. Cool post op pain
    code 64415 is not getting paid due to the use of icd 9 719.41. Does anyone know of a code to use with this pain block....that will not be denied?

    Thank you!!!

  7. Default Inter scalene block for post-op pain
    [QUOTE=kimweiser;228023]code 64415 is not getting paid due to the use of icd 9 719.41. Does anyone know of a code to use with this pain block....that will not be denied?

    Thank you!!![/QUOTE

    You now would use ICD 10 Cm code G89.18 in order to get your separate pain control injection done by anesthesia paid along with whatever side was injected with a -59 modifier as long as ansethesiologist dictates separate note and that surgeon is requesting for post-op pain.

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