# Billing Single Lumbar Plexus Blocks



## RPacheco (May 22, 2009)

Does anyone know the correct way to bill a 'single injection lumbar plexus block' for post op pain?  
Recently had a few denials from Medicare with the '59/52' modifiers. Want to see if anyone else is having the same problem. Thanks.


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## cbunti (Jun 17, 2009)

We are having the same problem but I do not know the solution.


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## jdrueppel (Jun 17, 2009)

I need a little more information before I can respond. 
Are you billing this for chronic pain OR postoperative pain management?  
Are you billing any other services for this date?

Julie, CPC


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## cbunti (Jun 23, 2009)

The injection is provided for post op pain management on the same day as the surgery.


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## jdrueppel (Jun 23, 2009)

On the few occasions my docs have performed a single lumbar plexus block  for postoperative pain management I've billed it as 64449-52 59 (reduced services / separately identifiable for postop pain). 

Julie, CPC


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## mitchellde (Jun 23, 2009)

are you linking this to a 338.xx code for acute post operative pain?


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## tadavis (Jul 7, 2009)

yes I would use 3338.28--other chronic post-op pain


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## jdrueppel (Jul 7, 2009)

If the purpose of the block is for postoperative pain management I would use dx code 338.18 and not a chronic pain dx code.

Julie, CPC


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## TammyW (Jul 9, 2009)

I agree 338.18 as your primary diagnosis ~ with your surgery diagnosis secondary.  
but I would also consider your mode of anesthesia as a possibility of your denial.  
also, 64449 description says "continuous infusion"...  I might would look at 64483.

Tammy, CPC, CANPC


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