“Saddle block”: Be prepared to appeal
<huc>Q</huc> How do you code a “saddle block” (spinal anesthesia confined to the perineum, buttocks, and inner aspect of the thighs)?
<huc>A</huc> 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).
If the procedure was performed by an anesthesiologist during vaginal delivery, the code is 01960 (anesthesia for vaginal delivery only).
This is in line with CPT guidelines, but some payers won’t reimburse delivering physicians for the block—so be prepared to appeal, especially if no anesthesiologist was available.