When and how procedural anesthesia and postoperative pain blocks are administered often play a role in procedure reimbursements for care.
There are various POP blocks available for anesthesiologists and patients, from epidurals and spinals to peripheral nerve blocks.
And for some physicians, the ability to be paid for these blocks is tied to the anesthesia technique used in the case, according to a May 30 blog post from Rita Astani, president of anesthesia for Coronis Health.
POP blocks and general anesthesia:
When general anesthesia is used, POP block reimbursement is typically easy. If it's a block approved by the payer, it does not matter if it is placed preoperatively or postoperatively. Reimbursement for postoperative placement can change if the anesthesia is anything other than a general.
Regional POP blocks:
When using a regional block as the main anesthetic, obtaining reimbursement for postoperative pain procedures becomes more difficult. If the mode of anesthesia is a regional block, you cannot bill separately for postoperative pain when the POP block is the same as the block used for interoperation.
If you used an epidural for the case anesthetic, you cannot additionally bill for a POP epidural. If the mode of anesthesia is either a general, spinal or epidural, you can bill a peripheral nerve block separately for postoperative pain.
Using monitored anesthesia care:
Providers may not bill separately for peripheral nerve blocks for postoperative pain management when their anesthesia mode is monitored anesthesia care.
Authors of Medicare reimbursement codes believe that a postoperative pain procedure performed prior to, or during, the surgery provides some measure of anesthetic relative to the operative session. Therefore, it is inappropriate to bill for postoperative pain separately.
If physicians perform the POP block after the surgical session where MAC was used as the mode of anesthesia, the door is open for a separate payment.