# 64450 - Patient has 3 fingers fractured



## 01051184 (Jun 25, 2013)

Patient has 3 fingers fractured on the same hand. Provider did a digital block on 2 . Can I bill for 2 and if so would it be a 51 or 59 modifier?

Thank you for any help.


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## dmaec (Jun 25, 2013)

it's my understanding that if the block was used for "anesthetic purposes" it's not separtely billable.  it's included in the procedure code for the fracture treatment.


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## cari@resolutionsbilling.com (Jun 25, 2013)

*if not for anesthetic purposes*

If the 64450 x2 is not for anesthetic purposes, you carrier may want it 2 different ways.  

64450x1 (indicate lt/rt/digits)
64450x1 76 (indicate lt/rt/digits

however for 2 Medicare macs that I bill this code to they want 64450x2 (indicate lt/rt/digits)

There has been a lot of talk and coding guidelines for this code as of late within Medicare.  Be prepared for a possible note review---again, if this is a separate service.


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## hi.prateekjain@rediffmail.com (Jun 27, 2013)

*postop pain management*

if anesthesia procedure was done same day 64450-59, 64450-51-59.
if post op pain management performed next day 64450, 64450-51.
i encounter this kind of scenario everyday. i have not seen any denial from insurances..

can not use modifier 76 because both blocks are given on diff digital nerves.


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## ramirez505 (Jul 13, 2013)

*digital block*

Hi, you say a digital block was done;  was the digital block done for pain management so Dr could examine Fx's or was a procedure actually done and if so what procedure?


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## marvelh (Jul 13, 2013)

You may want to consider using the corresponding finger modifiers, FA, F1-F9 to identify the location of the digital nerve blocks if they are separately billable.


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