ED Coding and Reimbursement Alert

Question: When is it appropriate to report a digital block? Is it always bundled?

Delaware Subscriber Answer: The only time you should report a digital block is when the physician performs it for pain relief and doesn't also perform a surgical procedure. For example, if a patient presents with severe pain from a wound, and the emergency physician administers a digital block, bandages the wound, and sends the patient home, you could charge for the block with 64450 (Injection, anesthetic agent; other peripheral nerve or branch).
 
If the physician plans to perform any surgical procedure, you should not bill for the digital block, because it's included in CPT's definition of the "surgical package." Instead, you should consider it as part of the medical decision-making element of the evaluation and management level you choose (99281-99285).