# CRNA pain mgmt injections



## Melissa*Ever*Evolving (Oct 11, 2011)

Hello, I am in dire need of assistance with finding out what injections CRNAs are allowed to perform in Indiana. A CRNA that I bill for is wanting to perform lumbar epidural injections, facet injections, and SI joint injections... 62311, 64493-5, 27096 ...

I believe I saw something on facet injection 64493 cannot be billed by CRNAs due to the fluoroscopic guidance being included and they cannot perform this. Is that correct? I can't remember where I saw this.

Please Help! Even a website to guide me in a directon would be helpful!

Thank you!

Melissa Rufenbarger, CPC


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## missyah20 (Oct 19, 2011)

Melissa,
  I would look on your Medicare carriers website to see if they have any restrictions.  I know that Noridian Medicare will not pay a CRNA for Chronic pain management.  I would also check with the Indiana board of nursing to make sure that they can do these procedures per state law.

It does state in the Medicare IOM 100-04 Chapter 12 section 140.4.3:

"Payment can be made for medical or surgical services furnished by nonmedically directed CRNAs if they are allowed to furnish services under State law.  These services include the insertion of Swan Ganz catheters, central venous pressure lines, PAIN MANAGEMENT, emergency intubation, and the pre-anesthetic examination and evaluation of a patient who does not undergo surgery."


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