# Post Op Pain



## enancy79 (Apr 14, 2009)

How would you bill ultrasound guided popliteal blocks by a CRNA while the anesthesia for the procedure is performed by a different CRNA, he would also like to bill for the medication.  What documentation is required for 76942 (professional component).  I'm leaning toward 64450-59 76942-26 and J3490  What suggestions /corrections do you have for this situation.  Thanks.


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## jdrueppel (Apr 15, 2009)

If the block is not being used as the mode of anesthesia I would bill: 
64445-59 (single injection popliteal block) OR 64446-59 (continuous)
76942-26   MUST save image and have clear documentation of ultrasound  "interpretation" 

I'm not sure of the rationale for billing J3490 - what unclassified drug are you supplying??

Of note, we have had some Medicare payment issues when 76942 is billed by CRNA.  Medicare has denied most as not billable by CRNA provider specialty.   

Julie, CPC


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## missyah20 (Apr 16, 2009)

Not to go off on a different topic, but we have had the same issue with 76942 being denied by Medicare when done by a CRNA.  Does anyone know where or if this can be found on Medicare's website?


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## enancy79 (Apr 16, 2009)

This provider is using propofol in the injection.  Is there a better code for this?  I'd be interested in know if others are having difficulty getting paid for these codes from commerical payers for services provided by a CRNA.


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## jdrueppel (Apr 22, 2009)

Are you coding this service in an office or facility setting?  I still trying to rationalize the need to code for the propofol.

Julie, CPC


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## enancy79 (Apr 24, 2009)

This was a situation posed to me by a potential client.  I believe his services were provided in an ambulatory surgery center facility.


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## jdrueppel (Apr 24, 2009)

If billing for the CRNA professional service(s) the propofol is not separately billable.  I don't do ASC billing so I'm unsure if it's billable by the ASC (facility) and you may want to pose this question under the ASC forum if you are billing for the facility.  

Julie, CPC


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