Wiki post op pain block

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cherie33

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Hello. So, I fully understand that post op pain blocks can be billed separately etc but my question is by whom? I code for the ASC and was recently thinking about this...it's the anesthesiologist doing the block...all the drugs, supplies, etc are included in our all encompassing fee, so wouldn't it be the anesthesiologist who is able to bill for the additional procedure, not the facility? An AAPC article I read talked a lot about whether or not it needs to be deducted from the total anesthesia time, timing of the block etc making it sound as though the whole thing was geared toward the anesthesia coders. Just looking for some clarification. Thanks!! Cherie
 
Modifier -59 must be attached to the CPT code for the injection to seperate bill from anesthesia otherwise you will get an inclusive denial.
 
Yes the Surgery Center can be reimbursed!!!! As you say the all encompassing fee is for the Surgery and the staff and the time and use of the facility. The post op pain block HAS TO BE DONE in the pre op area and with a procedure that is going to require General anesthesia. The charge is for the extra time and staff and use of the facility that is involved with getting the block.

That being said ...... I have yet to see a payment for it. Medicare wont. But I will keep trying with the others that we are contracted with. They should pay it.....:)
 
I bill post op pain blocks for an asc almost daily.
We always get paid, as long as it is in our contracts that these codes are reimburseable. Medicare will pay for it but you have to continuously appeal and prove to them by documentation that the doctor wanted this done by the anesthesiologist.
Do not leave money on the table, if its in your contracts, and it is properly documented then bill it!

Caprice--cpc
 
Here is what I got from Becker's asc review. "Controlling pain post-surgery is considered part of the global surgical package. Medicare will not allow you to bill for a post-operative pain block provided by the surgeon. The NCCI policy manual states, "Medicare global surgery rules prevent separate payment for post-op pain management when provided by the physician peroforming an operative procedure. National Billing Services believes that the pain block, if performed by the anesthesiologist, should be billed by the professional side only and not the ASC. FYI
 
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