Anesthesia Coding Alert

The anesthetic's delivery during a Bier block sets it apart from other anesthesia techniques. Usually, an anesthesiologist applies tourniquets proximal to the treatment area prior to injection and leaves them in place during the procedure.

"While the tourniquet is in place, the medicine is injected through an IV," says Trish Bukauskas, CMM, CPC. "All medication goes right to the extremity that is the subject of the intervention, thus relieving the pain."

The anesthesiologist normally injects the anesthetics around a nerve. With a Bier block (which is the most common type of intravenous regional anesthesia), he or she injects the anesthetic directly into the blood supply that feeds the nerves being treated. Bier blocks otherwise known as perfusion blocks are the only ones that involve administering the anesthetic intravenously rather than perineuronally.