Wiki Nerve block billing in an ASC

[dawnee]

I do coding/billing for an ASC and we just recently started billing for nerve blocks for post-op pain. We have met all the criteria that has been as far as documentation is concerned and have been successful in getting paid by most payers. However, we recently experienced an issue where Horizon BCBS of NJ has denied a couple of them stating that as an in-network provider that we cannot bill the blocks separately and that the block should be billed on the same UB-04 as the surgery and that we should list both doctors on the UB-04 (the actual surgeon who performed the surgery, and then the anesthesiologist who performed the block on the same claim form). I for one have never heard of this before and just wanted to know if anyone can advise me on this and if they've heard of this before.

 

[CROBINSON1988]

I do coding/billing for an ASC and we just recently started billing for nerve blocks for post-op pain. We have met all the criteria that has been as far as documentation is concerned and have been successful in getting paid by most payers. However, we recently experienced an issue where Horizon BCBS of NJ has denied a couple of them stating that as an in-network provider that we cannot bill the blocks separately and that the block should be billed on the same UB-04 as the surgery and that we should list both doctors on the UB-04 (the actual surgeon who performed the surgery, and then the anesthesiologist who performed the block on the same claim form). I for one have never heard of this before and just wanted to know if anyone can advise me on this and if they've heard of this before.

I also, work for an ASC, and our doctors do the nerve block for post op pain.
I was told to bill only 74942 with TC modifier and 59 but it depends on the insurance if we get paid on it or not. I also bill for the medication that is used to perform the nerve block.