Caution needs to be observed when reporting post-operative pain management (POPM). In accordance with NCCI edits policies, postoperative pain management is considered bundled in the surgical code(s). There are only a few instances where it may be billed separately.
Medicare Global Surgery Rules prevent separate payment for postoperative pain management when provided by the physician performing an operative procedure. CPT codes 36000, 36410, 62320-62327, 64400-64489, and 96360-96377 describe some services that may be utilized for postoperative pain management. The services described by these codes may be reported by the physician performing the operative procedure only if provided for purposes unrelated to the postoperative pain management, the operative procedure, or anesthesia for the procedure.
- National Correct Coding Initiative Edits Manual 2017
An article by Anesthesia Business Consultants provides further guidance on this topic. They state:
“Although postoperative pain is the responsibility of the surgeon and payment is bundled into the surgeon’s global fee, anesthesia services may be reported separately if there is a request by the surgeon for an anesthesia practitioner to provide POPM and anesthesia for the surgical procedure is not dependent on the efficacy of the regional anesthetic technique. The ASA Relative Value Guide® (RVG™) indicates that the following conditions apply:
Anesthesia for the surgical procedure was not dependent upon the efficacy of the regional anesthetic technique;
Time spent on pre- or postoperative placement of the block is separated and not included in reported anesthetic time; and
Time for a post surgical block that occurs after induction and prior to emergence does not need to be deducted from reported anesthesia time.”
See the References to review the complete article.
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