Anesthesia Coding Alert

Question: According to a coding website that we use, 01992 is included in 62326, but as long as we have the physician billing the procedure on one claim form and the anesthesiologist billing MAC on another claim form, is it okay to bill these codes?

New Hampshire subscriber

Answer: Anesthesia for this diagnostic or therapeutic nerve block is bundled by the National Correct Coding Initiative (NCCI) edits and cannot be unbundled for any reason, which includes reporting on a separate claim form. According to the NCCI, “Code 01992 [Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position] is a component of column 1 code 62326 [Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) …]. Only code 62326 will be reimbursed, and no modifiers are allowed to unbundle these services.

The American Society of Anesthesiologists (ASA) offers guidance to help in their Statement on Anesthetic Care During Interventional Pain Procedures for Adults. Based on this resource, most insurance payers will not allow separate payment.