ED Coding and Reimbursement Alert

Question: Can I charge 64450 (injection, anesthetic agent; other peripheral nerve or branch) times two, if two fingers are injected? Or, is this used when two different body parts are injected?

Helen Genic
Infinity Healthcare, Mequon, Wis.

Answer: You can charge 64450 twice if the physician does a digital block on two fingers. You can use a quantity of two or consider listing the code twice
with a location modifier. For example, you could code 64450-F1 (left hand, second digit) plus 64450-F2 (left hand, third digit).


Sources for Reader Questions: Penny S. Lodes, PN, CPC, president of Lodes and Associates, a coding consulting firm in Appleton, Wis.; Todd Thomas, CPC, CCS-P, president, Thomas & Associates, Oklahoma City; Michael Granovsky, MD, chief financial officer of Greater Washington Emergency Physicians, a five-physician group staffing a 24,000-visit ER, Maryland; Roger P. Holland, MD, PhD, FAAFP, physician reimbursement specialist, Utilization PRO Inc.; Mason A. Smith, MD, FACP, CEO Lynx Medical Systems, Bellevue, Wash.; Bart Hershfield, MD, FACEP, reimbursement committee chairman of the West Virginia chapter of the American College of Emergency Physicians (ACEP); Caral Edelberg, CPC, CCS-P, president of Medical Management Resources Inc., an emergency department coding consulting firm in Jacksonville, Fla.; and John Turner, MD, PhD, medical director for documentation and coding, healthcare financial services at TeamHealth, an ED staffing firm in Knoxville, Tenn.