When a block is billable on its own
- It's for pain after surgery, and the surgeon asked for it. Record the request.
- It isn't the main anesthetic. If the block is how you anesthetized the patient for surgery, it's covered by the anesthesia code.
- It's documented as its own procedure, with the block type, side, drug, any imaging guidance and who did it.
Don't count the time twice
If you place the block before anesthesia time starts, that's fine. If you place it during anesthesia time, the block time generally has to come out of your anesthesia time. Payers vary on details, so check yours.
Single shot or catheter
Single-injection blocks and continuous catheter placements have different codes. Daily management of a catheter after surgery is billed separately, and some payers don't pay for it.
Modifiers and edits
Because the block happens alongside the anesthetic, payers may need a modifier, such as 59 or an X modifier, to show it was a distinct service. Check the NCCI edits and your payer's rules.
Ultrasound guidance
Many block codes now include imaging guidance. Don't bill ultrasound separately when the block code already includes it.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
Sources
- CMS: Medicare Claims Processing Manual, Chapter 12 (Anesthesia)
- CMS: National Correct Coding Initiative edits