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https://www.supercoder.com/coding-newsletters/my-ob-gyn-coding-alert/reader-question-using-64435-article
Note that Medicare and CHAMPUS do not pay the physician who has performed the surgical procedure for any anesthetic administration associated with the procedure. If you code for the paracervical block, you will need to add a modifier -51 (multiple procedures) to the code as the CPT multiple procedure rules apply in this case.
https://www.supercoder.com/coding-newsletters/my-ob-gyn-coding-alert/reader-question-paracervical-block-article
The correct modifier is -51 (multiple procedures). CPT says local infiltration is included in the surgical procedure, but some will argue that a paracervical block is a regional anesthesia, not local. The payer, on the other hand, reads the description of the procedure as …
https://www.uptodate.com/contents/pudendal-and-paracervical-block
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https://www.aapc.com/discuss/threads/superficial-cervical-plexus-block-cpt.136554/
May 03, 2016 · Is it appropriate to report nerve block codes 64412, 64413, and 64418 more than one time per encounter if the injections are performed bilaterally? ... Note, modifier 50 can also be used for bilateral superficial cervical plexus injections (reported with CPT code 64413). Some payers may expect bilateral or multiple units of the same injections ...
https://codapedia.com/topicOpen.cfm?id=E7FD5B6B-7236-4074-B5D44D9F946FEA96
Jul 15, 2009 · Charging 64435, paracervical block with procedures. I think 64435, paracerivcal block, is included in procedures when done by the same surgeon in the office. CCI edits state that anesthesia cannot be charged by the physican who is performing the procedure. We have billed it with IUD insertions and it is always denied as included in the procedure.
https://www.aapc.com/discuss/threads/nerve-blocks.165446/
Apr 24, 2019 · 64405 is for the greater occipital nerve, which is a different site from the third occipital nerve that is documented here, so I don't believe that option is correct. 64490 is for a facet joint injection, which is an inter-articular injection and not a nerve block, …
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