# Billing Multiple Digital Nerve Blocks



## mgrimaldi (Mar 7, 2012)

We are treating a patient with Chronic Regional Pain Syndrome (CRPS) in the upper extremitiy. Our physician has performed a total of 8 digital nerve blocks (64450). We are billing a commercial carrier and are torn on how to bill this. When we bill 64450 in quantity of 8, the carrier is only paying for one of them. When we bill line by line (with 64450 listed 8 times) with modifier 51 (carrier allows) on lines 2-8,the carrier is paying line 1 and denying the rest as duplicates. We are hesitant to apply modifier 59 on lines 2-8, but seems that is the only way he gets paid for the add'l injections.

Anyone else encounter this?? Should our physician only get paid for 1 injection??

Any help is greatly appreciated


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## catrina.thomas (Mar 7, 2012)

It has been my experience that you can only bill the nerve blocks as a single or bilateral (by appending the modifier 50) procedure.  I didn't check the MU edits from CMS but if it is listed there, your commercial carrier may be following those guidelines.


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