Axillary + MC Billing.

[sevoflurane]

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Just curious if anybody is billing an Axillary block seperately from the Musculocutaneous.

In other words, since you are removing your needle (after axillary), scanning the coracobrachialis and independently finding the MC and re-inserting the needle + injecting local distal to your axillary block...do you bill for 2 different blocks or lump it under "Axillary Block"?

 

[Oggg]

How about intercostobrachial? What if you use the ultrasound to find it and inject it?

 

[Oggg]

Probably I'd lump the MC in as part I the brachial plexus block. But technically the intercostobrachial is not in the brachial plexus

 

[sevoflurane]

I've never billed a separate MC block for an axillary block, and although it is usually easy to get the MC... that little sucker evaded capture for 3-4 minutes today. 😡

I agree with you. I think the MC should be billed and lumped into a B.P. block.
I was at a meeting recently where someone did believe it could be billed as a separate "terminal branch" nerve block. I don't I buy it, but I also see the reasoning if you are moving further down the upper arm to block it.

Your ICB point is an interesting one as it truly is not part of the plexus. I’ve never billed for it that way, but I usually don’t go after it with USD as most my UE blocks are for POPM (ie, they go to sleep).

 

[Oggg]

Or maybe do a midhumeural block, and bill ulnar median radial musculocutaneous all separately 🙂

 

[sevoflurane]

Or maybe do a midhumeural block, and bill ulnar median radial musculocutaneous all separately 🙂

Don't forget the exparel at the incision site...