Q:  When a post op pain block is billed, should the appropriate anesthesia modifier be added as well, such as AA, or one of the Q modifiers if one of those are applicable?
A:  No, the CPT codes used for post op pain blocks and ancillary services when done separately from your ASA codes, are not reported with Anesthesia modifiers.

Q:  For those CPT codes that were mentioned that have a “separate procedure” designation in CPT, should we add a modifier such as 59 or one of the X modifiers?
A:  Yes, per the Surgery Guidelines for separate procedures in our CPT books, when a “separate procedure” is carried out independently or considered to be unrelated or distinct, it may be reported by appending modifier 59 (or Xx depending on carrier guidelines).

Q:  Occasionally we have a case where the block is performed intraoperatively. Do we need to deduct that from their time spent?
A:  No, when the post-operative pain procedure is placed after anesthesia induction or prior to emergence (intraoperatively), the time spent performing the block is not deducted from the total anesthesia time.

Q:  Do we have to have a written order for a postop pain block?
A:  A written order and/or some sort of written documentation is required showing that the surgeon requested the anesthesia team to participate in the post-operative analgesia.

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Mary is a consultant for The Haugen Consulting Group with over 25 years of health care industry experience. She started her career in Orthopedics which was her passion for decades. In addition to Orthopedics, she provides expertise in other specialties such as Anesthesia, Ambulatory Surgery Center, as well as most surgical specialties . She has experience working the professional fee side of coding, audit, education as well as compliance, serving both coders and physicians, as well as the surgical side. She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Anesthesia Professional Coder (CANPC) Certified Ambulatory Surgery Center Coder (CASCC) and Certified Orthopedic Surgery Coder (COSC).

During her free time, she loves to do crafts, enjoys the outdoors, and the Broncos! She has 4 daughters, and 10 grandchildren which light up her life.


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