Anesthesia Coding Alert
Eye Your Options for Retrobulbar Block Coding
Question: Our anesthesiologists sometimes administer a retrobulbar block for cataract and other eye cases. After doing some checking, it appears to me the block is a combined anesthesia and postoperative pain technique. Is it separately billable? If so, what code would be used?
Montana Subscriber
Answer: Surgeons sometimes request that an anesthesiologist administer retrobulbar blocks (67500, Retrobulbar injection; medication [separate procedure, does not include supply of medication]) because they’re riskier than other ocular injections, are pretty tricky to code particularly for Medicare and third-party carrier reimbursement.
Retrobulbar blocks are useful methods of achieving anesthesia for intraocular and orbital surgeries. They’re good alternatives to general anesthesia when general anesthesia is undesirable or contraindicated for some reason.
When your anesthesiologist performs the block, report 00140 (Anesthesia for procedures on eye; not otherwise specified).
There’s been some controversy in the past over whether you should only report the anesthesia code and applicable units, or also code any other injections administered during the procedure. Correct Coding Initiative (CCI) edits currently allow the anesthesiologist to capture discontinuous time for the retrobulbar block, when applicable. Don’t code for any other injections separately.
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