Anesthesia Coding Alert

Question: A patient had rotator cuff repair and knee arthroscopies done during the same encounter, with the anesthesiologist placing shoulder and knee blocks. Only the rotator cuff repair will be coded along with the shoulder block. The knee scope won’t be billed, but can we report the knee block since the anesthesiologist placed it?

Arizona Subscriber

Answer: Yes, you can bill for both blocks since they were administered to separate anatomic sites, providing the blocks were not used as the mode of anesthesia and documentation supports the surgeon requested for post-operative pain management. Both blocks should both be payable, but verify that the anesthesiologist’s documentation supports reporting the blocks separately (and be ready to appeal if the insurer denies the claim).

Also: If the anesthesiologist used ultrasound guidance for block placement, having photos on hand in case of appeal will be helpful.