Anesthesia Coding Alert

READER QUESTIONS:

Code Post-op Fascia Iliac Block as Peripheral

Question: An orthopedic surgeon has asked our physicians to begin administering postoperative blocks after total knee replacement procedures. Is it acceptable to perform fascia iliac blocks for these patients? If so, how should I code them?


Alabama Subscriber
Answer: Some pain specialists administer these blocks after total hip replacements, so performing them for knee replacements should be fine. Report the block with 64450 (Injection, anesthetic agent; other peripheral nerve or branch) and append modifier 59 (Distinct procedural service) to indicate the block is separate from anesthesia during the replacement surgery.
 
Many carriers- postoperative pain management policies require that you link diagnosis V58.49 (Other specified aftercare following surgery) to the postoperative pain procedure. Check whether this is the case so you can submit claims based on the carrier's guidelines.
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