09/26/2014 – 64448 With 99231

Question: The anesthesiologist re-administered a patient’s postoperative pain block the day after surgery. The patient was also seen by the same physician during rounds that day. What is the policy for billing 64448 and 99231 on the same day? 


Answer:   If you base your coding on Correct Coding Initiative (CCI) edits, the procedures are bundled together, with 64448 (Injection, anesthetic agent; femoral nerve, continuous infusion by catheter [including catheter placement]) as the primary/comprehensive procedure. If you have sufficient documentation showing that the services were separate and distinct from each other, however, you can report both codes on the same day. Append a modifier to 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: a problem focused interval …) to differentiate between the services.


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