Editor’s Note: Cutting through the red tape to make certain that you get paid for every dollar you earn has become more difficult than ever, particularly in our current climate of health care reform and ICD-10 transition. The ACEP Coding and Nomenclature Committee has partnered with ACEP Now to provide you with practical, impactful tips to help you navigate through this coding and reimbursement maze.

Question: Can I bill for a nerve block?

Answer: Trying to reduce opioid use? Nerve blocks are a safe alternative for pain control, but can you bill for them? Yes and no. If you are performing the nerve block as part of a surgical procedure, then no. The nerve block is included (bundled) in the procedure code. However, if you are performing the nerve block without a surgical procedure, you can bill for it. A real-life example is if you perform a digital block to repair a laceration, then the digital block cannot be billed separately. If you do a digital block to alleviate the pain of a crushed finger, however, then you can bill separately for the digital block.

How much is the reimbursement for a digital block? The Medicare Physician Fee Schedule for CPT code 64450 is $81, so document your digital block well. There is also a code for trigeminal nerve block for dental pain (CPT code 64400, $130 on the Medicare Physician Fee Schedule). This includes blocks for the infraorbital and inferior alveolar nerves.

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