# digital block-If anesthesiologist



## alk@APS (Jun 28, 2012)

If anesthesiologist is present and monitors a pt during a procedure but the only anesthesia provided is a digital block on a finger wound repair how is that billed? Do I need to add a modifier to show just a block? Or is it just billed on time?


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## aaron.lucas (Jun 28, 2012)

personally I wouldn't bill anything, the anesthesiologist isn't performing any anesthesia service, and really I dont think even needs to be there.  Is there any special reason/condition that necessitates the separate observer?  When I had stitches done on my hand it was just the doctor doing the repair in the room.  And I wouldnt bill for the block either, because the laceration repair would probably have at least a same day global, and digital blocks are included in the package.


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## syllingk (Jun 28, 2012)

Did the doc doing the laceration repair do the nerve block?


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## alk@APS (Jun 28, 2012)

The anesthesiologist did the block and started an IV and remained in the OR in case the patient needed more anes than just the block.


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## syllingk (Jun 28, 2012)

I would use 64450 as this can be upper or lower extremities. I do not agree that the block is included in the global for the surgery. That is only if the physician doing the procedure does the pain control.


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## aaron.lucas (Jun 28, 2012)

yeah but I would still be careful about that.  like I said when I had my stitches the doc doing the repair did the block himself, there was no need for anyone else, so something like that may get denied for not being necessary.


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## DeeCPC (Jun 28, 2012)

I agree with aaron that the block is normally bundled with the closure. This could be seen as unbundling.

I coded for ER for 4+ years and have never heard of anesthesiology involved in a laceration repair.


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## alk@APS (Jun 29, 2012)

So if the procedure is a wound repair just say a 13120 and the method of anesthesia is a block you would not crossover to an 00300 but use a nerve block code? Even if they start an IV and stay and monitor throughout the procedure and doc doing the repair did not provide the block?


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## lenora rodes (Jun 29, 2012)

If the anesthesiologist performed a digital block as the mode of anesthesia for the surgeon's repair of the laceration then the appropriate ASA code with the anesthesia care time should be submitted. If the finger laceration repair involved the integumentary system then 00400 is appropriate. If the tendons are repaired then 01810 should be submitted.

Lenora Rodes, CPC, CANPC, COBGC


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## syllingk (Jun 29, 2012)

I agree with Lenora.  And don't forget the MAC modifier. The anesthesia is not bundled with the closure because the anesthesiologist isn't doing the repair.


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## alk@APS (Jul 1, 2012)

Thank you all so much for helping me clear that up


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## jayne (Sep 4, 2012)

*agree*

I agree that it should be billed.  Every case is different.  If an anesthesiologist was used in addition to the surgeon for this procedure, I would certainly bill it.  I agree that if the surgeon performed the anesthesia, it would not be billable.


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