# Help!! Mod.-51 for post-op pain mgmt



## FractalMind (May 20, 2009)

Hi, I'm anesthesia coder and we often code epidural injections/catheters and blocks for post-op pain mgmt, we have always appended mod. -59 for all pain mgmt procedures along with the anesthesia services, here's an example:

715.96
27447
01402=7
62319-59=9
64445-59=7
64447-59=7

Is this correct?

our doctors often do more then one of these together, but recently our Mgr told us that we need to append -59 to the 1st & higher unit injection/block/catheter and -51 modifier to the rest of the procedures, here's how now we have to code:

715.96
27447
01402=7
62319-59=9
64445-51=7
64447-51=7

I've been researching and cannot find anything on mod-51 to be used for post-op pain mgmt, I believe using -59 modifier for all post-op injections/blocks done on the same day was Right, what do you think?


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## jdrueppel (May 20, 2009)

I too bill for anesthesia.  We have not been instructed to, nor do we bill the -51 modifier on any of the blocks.  In addition, on those blocks that you do not bill the -59 modifier, they will deny as inclusive as you are not giving the payer any information to indicate that it's separately payable/not the mode of anesthesia.

Just curious, in this scenario you indicate continuous epidural, single sciatic and single femoral blocks all for postoperative pain management.  That's alot of block!  For example - if the patient has a continuous epidural they are numb below the waist -- why would they need the short acting femoral and sciatic blocks?  Are you sure the continuous epidural --OR-- the femoral/sciatic blocks were not the mode of anesthesia and, therefore, not separately billable.  

Julie, CPC


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