Anesthesia Coding Alert

Question: The anesthesiologist administered an interscalene brachial plexus block and general anesthesia during a right shoulder arthroscopic debridement and Bankart revision, capsulorrhaphy. How should I code this?

Nevada Subscriber

 Answer: First, the surgeon needs to provide a written request for postoperative pain control so the block isn't considered part of the normal course of anesthesia. Once that's in hand, code the interscalene block as 64415* (Injection, anesthetic agent; brachial plexus, single) with modifier -59 (Distinct procedural service), if it was administered for postoperative pain control (you can't code for the block if it wasn't used for post-op pain control because it's included in the global anesthesia fee).

 You should link V58.49 (Other specified aftercare following surgery), the primary diagnosis code, to the block. Some carriers may also want a site-specific diagnosis code, in which case you should use 719.41 (Pain in joint, shoulder region).