Remember: Remember modifier 59 helps you
You must have been occupied with new as well as revised procedure or diagnosis codes, however don't forget the coding guidelines that are associated with CPT®, HCPCS, or other sources. Instance: The 2012 Correct Coding Initiative (CCI) coding guidelines include vital information about reporting post-operative pain management that your anesthesia providers will require knowing. Read on this expert medical billing and coding article for details on what CPT codes apply.
Check Timing and Clarify Purpose
Medicare global surgery rules specify that the surgeon performing the procedure is responsible for post-op pain management and should not report the care separate from the surgery. The rules change, however, when the surgeon asks the anesthesiologist or pain management specialist to handle the patient's post-op treatment.
Before asking for an anesthesiologist's help, the actual or postoperative pain should be severe enough to need treatments beyond the experience of the operating physician, as per CCI guidelines. For instance, the surgeon might request that the anesthesiologist place an epidural or nerve block to treat the patient's post-op pain.
Remember: The anesthesiologist might choose to place the epidural before, during, or after the surgery. You can only code the service, however, if the line for the epidural or nerve block is not also used for anesthesia administration during surgery. If it is, you should only report the appropriate anesthesia CPT code for the surgery and not separately code for post-op management.
After you can legitimately report the post-op management, look at following CPT codes as options:
You must have been occupied with new as well as revised procedure or diagnosis codes, however don't forget the coding guidelines that are associated with CPT®, HCPCS, or other sources. Instance: The 2012 Correct Coding Initiative (CCI) coding guidelines include vital information about reporting post-operative pain management that your anesthesia providers will require knowing. Read on this expert medical billing and coding article for details on what CPT codes apply.
Check Timing and Clarify Purpose
Medicare global surgery rules specify that the surgeon performing the procedure is responsible for post-op pain management and should not report the care separate from the surgery. The rules change, however, when the surgeon asks the anesthesiologist or pain management specialist to handle the patient's post-op treatment.
Before asking for an anesthesiologist's help, the actual or postoperative pain should be severe enough to need treatments beyond the experience of the operating physician, as per CCI guidelines. For instance, the surgeon might request that the anesthesiologist place an epidural or nerve block to treat the patient's post-op pain.
Remember: The anesthesiologist might choose to place the epidural before, during, or after the surgery. You can only code the service, however, if the line for the epidural or nerve block is not also used for anesthesia administration during surgery. If it is, you should only report the appropriate anesthesia CPT code for the surgery and not separately code for post-op management.
After you can legitimately report the post-op management, look at following CPT codes as options:
- CPT code 62310 or 62311 ( Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid …)
- CPT code 62318 or 62319 – (Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid …)
- CPT code 64400-64530 – (Introduction/injection of anesthetic agent (nerve block), diagnostic or therapeutic procedures on the extracranial nerves, peripheral nerves, and autonomic nervous system)
Append modifier 59 (Distinct procedural service) to specify that the anesthesiologist placed the nerve block or epidural for post-op management in place of intraoperative anesthesia. Remind the anesthesiologist to involve a procedure note in the patient's record documenting the block's purpose.
Medical Billing and Coding Tip: Watch Details of Post-Global Help
The surgeon might from time to time demand pain management services after the postoperative anesthesia care period ends. You can certainly code for this situation without thinking much about the fact that the care might be misconstrued as part of the surgical anesthesia. Though, CCI guidelines make clear that you still must append modifier 59 to the correct code for pain management services.
Medical Billing and Coding Tip: Watch Details of Post-Global Help
The surgeon might from time to time demand pain management services after the postoperative anesthesia care period ends. You can certainly code for this situation without thinking much about the fact that the care might be misconstrued as part of the surgical anesthesia. Though, CCI guidelines make clear that you still must append modifier 59 to the correct code for pain management services.
Nice blog... The importance of efficient post-operative pain management has led to the development of acute post-operative pain management teams... Their aims are post-operative pain assessment and treatment using various methods, including PCAs or PCEAs, and education of medical and nursing staff. Such services have been shown to improve pain relief, decrease analgesic medication-related side-effects... Pain Management Billing
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