# Bier Block for Carpal Tunnel Release (Newbie)



## sweetybird0472 (Apr 26, 2011)

Hello all, I hope someone can clarify this for me.

I have an operative report for a carpal tunnel release with a bier block.  The procedure description does not state if the physician or an anesthesiologist administered the bier block.

I found this article http://www.supercoder.com/articles/articles-alerts/aca/reader-questions-verify-bier-blocks-purpose/  that discusses this to an extent.

So what I was wanting to know is


If the physician did indeed administer the bier block, would I add modifier 47 to the 64721 code for the carpal tunnel release in addition to the 01810 code for the anesthesia?
How do I determine who administered the anesthesia if the procedure does not specifically state?

Thanks,
Christy


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## dwaldman (Apr 26, 2011)

01995 Code deleted effective 12/31/2006 

The link from 2005 you provided  is prior to the code being deleted. 

I would review the record available, might be additional sedation being provided other than soley a bier block and depending on the facility performed, the anesthesia for the case was probally provided by a provider other the performing physician.

Based on NCCI edits 01810 is column two code of column one code 64721 and modifier is not allowed.

 I also believe that the physician performing the procedure can not also report the anesthesia code like 01810  from a standpoint other NCCI issues.


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## nncymac@pinehurst (Apr 28, 2011)

*Sleepdoc-coder*

The Anesthesia Record should list who placed the Bier Block. It is my experience as an OR nurse that the CRNA/Anesthesiologist places the Bier Block, but the Anesthesia Record should have the provider listed.


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