How many injections in same day

[Phyzicz]

Hi guys, i do a lot of ankle blocks and headache blocks. Many of these blocks need 64450 a few times (block of a peripheral nerve). Ankle block is 64450 x 5. Some of the headache blocks have different named nerves (greater occipital, trigrminal nerve branches, etc for example) though. How many nerves/cpt's would I be reimbursed for these two slightly different scenarios?
My biller told me max 2 blocks reimbursement on both (even with different CPTs on headaches) so my other injections are a waste of time. True?
One last thing: is this true with everything for example GTB and hip injection, pointless to do both? Thanks for any advice.

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[bedrock]

1-your biller is wrong
2- why are you routinely blocking all the nerves in the ankle?

 

[Phyzicz]

Thanks for your reply. Can you shed a little more light on what aspect is wrong- can I do multiple nerve blocks with same cpt code (ankle) and different cpt codes (headaches) without a reimbursement problem?
The ankle block is for patients who have focal non-discogenic ankle/foot pain like after a chronic fracture or hardware.

 

[nvrsumr]

Try ankle intra-articular if anterior and pes anserine if lateral. Have hit a couple home runs on fused ankles.

U can bill x5 just get paid less for each onez if diff dx use a 59 mod

 

[Ducttape]

Be wary of doing separate blocks on different conditions on the same day if it is a Care patient. Check your LCD. Some do not allow different procedures on same day without extenuating circumstances (eg holding anticoagulation)

 

[lobelsteve]

Anyone care to ask what literature you can use for ankle blocks for outpatient pain to support this treatment?

 

[DOctorJay]

Try ankle intra-articular if anterior and pes anserine if lateral. Have hit a couple home runs on fused ankles.

U can bill x5 just get paid less for each onez if diff dx use a 59 mod

Pes anserine is medial knee at insertion of sartorious, gracilis, and semitendonosis.

 

[nvrsumr]

Yes sorry sinus tarsi.