tci General Surgery Coding Alert - 2002 Issue 6

Reader Question: Pain at Trocar Site

Question: After undergoing a laparoscopic cholecys-tectomy, the patient returned to the office for a postoperative check, complaining of severe pain at the trocar site. The surgeon injected the patient with a peripheral nerve block. What diagnosis code should we use? Also, can we bill for the nerve block? Arizona SubscriberAnswer: The nerve block is not payable separately by Medicare, which considers any type of postoperative pain management as included in the laparoscopic cholecys-tectomy's 90-day global period. The only exception for Medicare patients is if the patient must return to the operating room. In such cases, the appropriate pain management...

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