# ASC Post op pain blocks



## ASC CODER (Feb 24, 2010)

Does anyone have information from Medicare about billing post op pain blocks for pain management ie 64417. Are they not paying it anymore and considering it packaged now? This is specifically for the facility charge. I can't find any documentation that Medicare has put out. 


Can anyone help?

Thanks


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## hanoz420@hotmail.com (Feb 26, 2010)

*Interscalene block with RTC procedure*

Hi,

I too would like to know if there's any information out there that can guide be on what is required when the physician wants to bill an interscalene block in addition to the anesthesia provided for the shoulder surgery.  I understand it can be billed together, but what is required in the physician documentation in order for me to bill for this charge, and what code would I use?  Any help would be greatly appreciated!

Thanks!


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## hgolfos (Feb 26, 2010)

For interscalene blocks you need to have a surgeon's order requesting the Anesthesiologist to provide it in the record.  Bill with 64415-59 and primary dx 338.18 (acute post operative pain) or V58.49 if the patient has medicare-until March 1st then you can use the 338 code for Medicare also, use the surgery dx for the secondary dx.  

For example: 

29827 (01630)
840.4
338.18

64415-59
338.18
840.4

Hope this helps.


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## hanoz420@hotmail.com (Mar 2, 2010)

*Thanks!*

Thanks for the much needed input!




hgolfos said:


> For interscalene blocks you need to have a surgeon's order requesting the Anesthesiologist to provide it in the record.  Bill with 64415-59 and primary dx 338.18 (acute post operative pain) or V58.49 if the patient has medicare-until March 1st then you can use the 338 code for Medicare also, use the surgery dx for the secondary dx.
> 
> For example:
> 
> ...


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## ASC CODER (Mar 4, 2010)

We are being told that Medicare won't pay for pain blocks with a same day procedure other than anesthesia Anymore!!! regardless of dx or anything. I was wondering about any documentation on this?


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## hgolfos (Mar 5, 2010)

LGentry, 

Do you have an example?  your post says "other than anesthesia" the scenario above was for anesthesia...


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## ASC CODER (Mar 5, 2010)

25310
64417 (for post op pain other than anesthesia for primary procedure not done by the surgeon.)

this is the facility charge not surgeons


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## hgolfos (Mar 5, 2010)

Ok, you're not billing for the physician who performed the block, you're billing for the facility fee?  I don't really know anything about facility billing, only physician.  I'm sorry, I missunderstood your question.


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