Wiki ASC BILLING FOR POST OPERATIVE PAIN BLOCKS

[cherylbr]

My question is for facility billing for a post operative pain block provided by the anesthesiologist preoperatively during an orthopedic procedure done by an orthopod.

The surgeon (orthopod) requests the block from the anesthesiologist for post operative pain relief and notes it in the operative report.

The anesthesiologist provides the block and submits his/her claim for the general anesthesia, along with the block code.

The facility is billing for the procedure and also the pain block with a modifier XP on the block.

We are not having any problem with getting reimbursed on the anesthesiologist claim however, the carrier is denying payment on the pain block portion to the facility.

I 've been told that for outpatient hospital claims under OPPS reimbursement, the nerve block code is packaged into the APC payment rate for almost every surgical procedure. Does this mean that the nerve block is not separately reimbursable? Should we be billing for the facility for the nerve block?

I am confused because the ASC payment indicators are showing as A2 on some of the pain blocks being administered.

Please, anyone, give me your input on this. I am in need of help on this ASAP.

Thanks,
Cheryl Br.

 

[nickelclaw]

as long as anesthesiologist documents for post op pain then yes facility can charge with XP mod with G89.18 as dx make sure that he puts in his documentation. It wouldn't be appropriate to code dx from op report. For the pro side try using XU, XS. This is considered a seperate procedure than say a usual nerve block that is included in surgical package.
www.beckersasc.com/asc-coding-billing-and-collections/reporting-perioperative-peripheral-nerve-blocks