BCBS of Kansas Medical Policy Update

BCBS of Kansas Medical Policy Update

by abilling, December 1, 2015

Title:   Regional Nerve Block and General Anesthesia

 Current Effective Date:   November 6, 2015

 

DESCRIPTION

Regional nerve blocks are a form of pain management lasting 10 to 12 hours depending on the technique. A regional nerve block is placed preoperative or postoperatively for postoperative pain control to decrease the need for narcotics and patient-controlled analgesia (PCA) machines. Regional Nerve Block and General Anesthesia Page 2 of 10 Current Procedural Terminology © American Medical Association. All Rights Reserved. Contains Public Information

 

POLICY

A. A regional nerve block will be allowed preoperatively for pain control along with general anesthesia for the following:

  1. Shoulder surgeries (arthroscopic or otherwise) that involve cutting or drilling of the bone including placement of suture anchors.
  2. Knee surgeries – ACL (anterior cruciate ligament), Fulkerson, High Tibial Osteotomy, and Total knee replacement, repair, or revision.

B. A regional nerve block will not be allowed preoperatively for pain control along with general anesthesia for the following:

  1. Diagnostic arthroscopic shoulder surgery that does not involve cutting or drilling of the bone or placement of suture anchors
  2. Knee surgeries not listed above
  3. All other surgeries not listed

C. A regional nerve block will be allowed postoperatively for pain control following general anesthesia for any condition.

D. A regional nerve block would be appropriate for both inpatient and outpatient settings.

 

DOCUMENTATION

The medical record must indicate when the regional nerve block was done.

 

 

abinsights Contact Information

abinsights readers are invited to submit comments, questions, tips, and suggestions for articles on any subject related to billing, collections, coding, reimbursement, and compliance.  Send to:  Anesthesia Billing, Inc.,     P O Box 388, Newton, KS  67114-0388.  Phone 316-281-3700.  Fax 316-282-4322.

Our purpose is to help you meet inevitable challenges.  We hope to deliver practical knowledge and solutions drawn from top resources and business publications in every issue, knowledge you can use today.

Reasonable attempts have been made to be accurate.  However, medical billing, collections, coding and compliance are part science, part art, and even experts sometimes differ.  Neither Anesthesia Billing, Inc., the editors, publisher, contributors, or consultants warrant or guarantee the information contained will be applicable or appropriate in all situations.  For information specific to your practice, consult a qualified professional.

The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice.  Specific questions about how this information affects your particular situation should be addressed to your attorney.

Editor:  Philip Blann (pblann@anesthesiabilling.com).

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