# Closed Reduction w/digital block



## Lois Helms (Oct 1, 2008)

I work in the Revenue and Reimbursement dept of our facility.  Scenerio:  pt has a closed reduction with a digital block per dictation.  Should the ER coder code for a closed reduction WITHOUT anesthesia but also code for a digital block?  Codes used were: 64450 and 28630.  Please assist. 

Thanks,


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## tammyboyer (Oct 3, 2008)

I am not sure i understand the question but here is what I think you are looking for.  If the ERP did a closed reduction with anesthesia........then the CPT code needs to be the code that says closed reduction WITH anesthesia for the ERP services.  "With anesthesia" does not mean you are billing for the anesthesia...it is simply saying this procedure was done with anesthesia, some dislocations would not require anesthesia, other dislocations may be such that anesthesia needs to be used because it is more complex or may be too unbearable for patient without it; therefore making it more difficult for the reduction


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## tammyboyer (Oct 3, 2008)

sorry, i misunderstood your question.  You are saying "digital block" not anesthesia.  You would use the code without anesthesia in this case.  Digital block is "bundled" into the closed treatment with reduction CPT code for the ERP seervices..  Sorry for the confusion.


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## Lois Helms (Oct 6, 2008)

Thanks Tammie


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## grovey (Oct 12, 2008)

If the digital block was charged separetly, then use the no anesthesia code. You can not double charge


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## sam_son  (Oct 12, 2008)

Hai 
Digital block is bundled with closed reduction , so we cant bill digital block with closed reduction , please refer with CCI edits , for bundling issues
with regards
Samson CPC-A


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## lynne6257@comcast.net (Jul 7, 2009)

In the ER, patient had an accident with a knife at home and needs the laceration closed.  The physician gave patient a digital block (64450) and tetanus inoculation.  The ER level is coded 99283.  The claim was billed to networkcare and was initially paid for but then payment was retracted and was asking for a modifier.  I'm not sure what modifier they are looking for, can you help?


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## mitchellde (Jul 7, 2009)

The 99283 needs a 25 modifier


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