ED Coding and Reimbursement Alert

Question: Can I get paid for providing digital blocks?

Maine Subscriber

Answer: For most payers including those following CPT^® guidelines, this service can no longer be separately coded, when performed as a component of a surgical procedure. In this instance, digital block is clearly bundled as part of the global surgical package, as outlined in the CPT^® Introduction to the Surgical section-CPT^® Surgical Package Definition. Under Medicare’s global services package rules, digital blocks have always been bundled when performed as a component of a surgical procedure. However, digital blocks performed as a stand-alone procedure and not part of a surgical package, (e.g., for pain control alone) generally remain separately codeable under both Medicare and CPT^® coding principles.

If you do have a stand-alone digital block, such as a patient with a complex metacarpal fracture that the ED physician provides pain control with a digital block and then the hand surgeon takes the patient to the operating room you would report that service with code 64450 (Injection, anesthetic agent other peripheral nerve or branch).