Eli's Rehab Report

Question: A physiatrist performed a digital nerve block on a partial amputation and then sent the patient to a hand specialist. What code should I use for this injection?


North Carolina Subscriber

Answer: You should report 64450 (Injection, anesthetic agent; other peripheral nerve or branch).

Keep in mind that you may have payer issues when reporting this code because, most often, physicians perform surgical procedures to repair the partial amputation on the same day that they administer these injections. Typically, you should include any digital block in the global surgical package when performed by the surgeon.
 
If the payer denies your claim, appeal to let them know that clearly a different provider performed the injection prior to the hand surgeon's evaluation.

You may want to include in your appeal letter that the physician did not perform the digital nerve block for anesthesia for the surgical procedure but as a means of pain control prior to the surgeon's evaluation.