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• Nerve Blocks:
• Regional nerve blockade, or more commonly nerve block, is a general term used to refer to the injection of local anesthetic onto or near nerves for temporary control of pain. It can also be used as a diagnostic tool to identify specific nerves as pain generators. Permanent nerve block can be produced by destruction of nerve tissue.
• Examples of nerve block procedures with anesthetic delivered by injection include:
• Brachial plexus 64415
• Axillary 64417
• Sciatic 64445
• Femoral 64447
• Other peripheral nerve or branch 64450
• Examples of nerve block procedures with anesthetic delivered by continuous infusion by catheter include:
• Brachial plexus 64416
• Sciatic 64446
• Femoral 64448
• Lumbar plexus 64449
• Coding Tips:
• Modifier 51 is appended to reflect an additional procedure performed at the same session by the same provider.
• Modifier 59 is appended to indicate a procedure or service was distinct or independent from other services performed on the same day. It also identifies procedures/services that are not normally reported together, but are appropriate under the circumstances.
• The insertion and administration of an epidural or major nerve catheter (CPT codes 62318, 62319, 64416, 64446, 64448, and 64449) by an anesthesiologist for anesthesia purposes during a surgical procedure is included in the anesthesia management service code and is not separately reimbursable. The appropriate anesthesia code must be submitted with an anesthesia modifier(s) and time for the procedure.
• An injection or catheter insertion before, during, or following the surgical procedure for postoperative pain management is a separately reimbursable service. Modifier 59 must be appended to the appropriate procedure code to indicate a distinct procedural service was performed. The artilce is written by medical coding training provider
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The Healthcare Common Procedure Coding System (HCPCS) is divided into two principal subsystems, referred to as HCPCS Level I and HCPCS Level II.
Physicians and other health care professionals are required to use CPT to identify treatment procedures on insurance claim forms and elsewhere.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required that the Department of Health & Human Services develop standards for electronic data storage and transmission. Four yours later, the Department published the Final Rule, which selected CPT for reporting physician services (and other medical services) and International Classification of Diseases (9th revision, Clinical Modification), also known as ICD-9-CM for reporting diagnosis codes. Medical coding training online covers all these in detail.
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How to Code Using CPT
1. Identify the procedure, tests, services, etc. from the source document (i.e., medical record, superbill, etc.). Look for any modifying or extenuating circumstances.
2. Identify main terms and subterms.
3. Locate the procedure or service in the Index by checking procedure, anatomic site, synonym, eponym or abbreviated entries.
4. When you have found the entry in the Index, identify the code number next to it and refer to that code section in the main body of the manual. Be sure they match.
5. If a range of codes is given for the procedure, read the description of each entry within the range to make the proper selection that matches or fits as closely as possible to what was actually done.
6. NEVER code directly from the Index! Always verify codes in the main body of the CPT.
7. Ensure you have followed all notes and guidelines at the beginning of the section.
8. If the exact code is not what you are looking for, you may want to use a modifier.
9. If there is not a proper code, you may have to use the unlisted procedure codes in that section. Only use these as a last resort.
CPT Coding Examples
For inexperienced CPT coders to become oriented to the CPT manual, it is recommended to search for procedures with the help of the Index. The Index is printed in the CPT manual in the end pages of the book. The Index is organized by main terms. Each main term can stand alone, or be followed by up to three modifying terms. The reason is Anatomy for medical coding is important for all coding issues.
The Index is NOT a substitute for the main text of the CPT codebook. Even if only one code appears, the user must refer to the main text to ensure that the code selection is accurate.
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