# Clarification Needed - Digital Nerve Blocks



## Melissa Harris CPC (Nov 5, 2014)

Can someone clarify how to bill this?  Is it 6 units?


RIGHT HAND/DIGIT NB



ANESTHESIA: Local

PREOPERATIVE DIAGNOSIS: Digital neuropathy post traumatic amputation of the second third and fourth digits on the right hand.
POST-OPERATIVE DIAGNOSIS: Same

INDICATIONS: Pain in the digits of the right hand

DESCRIPTION OF PROCEDURE: After written informed consent was obtained from the patient and benefits and risks discussed including but not limited to: Benefits being pain relief.  Risks being infection bone nerve damage intravascular injection causing infarct of soft tissue.

The patient is brought to the procedure room and is seated on one of the chairs.  His right hand is placed on the procedure room table, and it is prepped with Betadine in sterile fashion.  Injection is performed on either side of the each of the digits stumps utilizing a half cc on each side of a mixture of 6 mg of betamethasone and 3 cc of 0.25% Marcaine.  Needle removed puncture wounds were dressed patient tolerated the procedure well.

Any help is greatly appreciated!

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management


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## Amy Pritchett (Nov 5, 2014)

In this situation, the CPT code would be 64450. NCCI guidelines state as well as MUE edits that only 1 injection per digit per day. Therefore this would be 3 units not 6.

Hope this helps


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## Melissa Harris CPC (Nov 5, 2014)

Thank you!  That was what I was thinking but the physician stated six.  
Melissa Harris, CPC


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## Amy Pritchett (Nov 6, 2014)

Anytime!!! Glad I could help


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