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Nerve Block and MEdicare

  1. Default Nerve Block and MEdicare
    Medical Coding Books
    Can someone direct me to guidelines on how to bill for peripheral nerve blocks (64446) and the facility for the surgical procedure itself? For example, the anesthesiologist provides the block using US, a CRNA provides anesthesia during the surgical procedure such as an austin bunionectomy. I know the US is bundled into the facility fee but some are saying the block can not be billed by the facility unless it is the sole method of anesthesia. Any guidance would be greatly appreciated.

  2. #2
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    Quote Originally Posted by KRISIEFER View Post
    Can someone direct me to guidelines on how to bill for peripheral nerve blocks (64446) and the facility for the surgical procedure itself? For example, the anesthesiologist provides the block using US, a CRNA provides anesthesia during the surgical procedure such as an austin bunionectomy. I know the US is bundled into the facility fee but some are saying the block can not be billed by the facility unless it is the sole method of anesthesia. Any guidance would be greatly appreciated.
    If it's just the block you can bill to medicare. If it's a post-op pain block (2nd to another primary procedure), it's bundled into primary procedure. e.g. pt has a shoulder arthroscopy & anes. gives a 64415. you can't bill 64415 because it's bundled into shoulder arthroscopy.

    I'm not sure who your Medicare carrier is. I'm in southern California (Palmetto GBA) and our LCD is #L28240 "Blocks & Destruction of Somatic & Sympathetic Nerves". hope this helps.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

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