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August 2004 · Vol. 16, No. 8

Reimbursement Adviser

“Saddle block”: Be prepared to appeal

Melanie  Witt,  RN, CPC, MA

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Q

How do you code a “saddle block” (spinal anesthesia confined to the perineum, buttocks, and inner aspect of the thighs)?

A

If you, as the delivering obstetrician, performed the saddle block, add modifier -47 (anesthesia by surgeon) to the delivery code, then add 62311-51 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]; multiple procedure).

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