# Femoral and Sciatic blocks



## consultingbykristin (Feb 19, 2014)

Question--

Physicians are documenting femoral and sciatic blocks.  Sometimes femoral and popliteal blocks done at the same time.

Is it appropriate to bill for both a femoral and sciatic block at the same time?  Is there guidance to refer to either way?

Thanks in advance.


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## dwaldman (Feb 19, 2014)

I found multiple references on a internet search for a combined femoral sciatic nerve block for total knee arthroplasty post op pain. I would believe whether it this combination or the at the popliteal space, it seems there clinical benefit from performing multiple blocks during the same setting.


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## danachock (Mar 1, 2014)

*sciatic & femoral nerve block*

Yes you may bill for each the femoral 64447 and the sciatic 64445 nerve block at the same time. Also each nerve block will need a modifier 59. 
You will need to make sure that each nerve block has a beginning and end time - that doesn't overlap for each nerve and the time can't be part of the procedure. 
So for example a TKA is being done. The MD will put 1100 to 1105 for the femoral block and 1106 to 1110 for the sciatic and the procedure began at 1140. It is also recorded in the record that the nerve block was done per surgeon's request, pre-operatively for post operative pain management. 
Notice: Not all insurance companies will pay for the nerve blocks - they will bundle this with the primary procedure. 
I hope this helps, 
Dana Chock, CPC-A, CCA, CANPC, CHONC
Anesthesia, Pathology, and Laboratory Coder


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