Can you really get a job doing only regional blocks?

[combatwombat]

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Can anyone comment on this? I've heard people talk about this but it sounds too good to be true.

 

[BobBarker]

No, but there are jobs in ortho hospitals where you place 20 blocks a day and loosely supervise CRNAs.

 

[caligas]

Can anyone comment on this? I've heard people talk about this but it sounds too good to be true.

If you did people would probably call you "block jock" which would be pretty sweet.

 

[epidural man]

Can anyone comment on this? I've heard people talk about this but it sounds too good to be true.

no

 

[Oggg]

Academics? A nerve block service?

 

[aneftp]

Academics? A nerve block service?

Yep. About the only place you can primarily just blocks.

But even than you will still be require to over see 1-2 rooms must because of staffing issues at most places.

Than while most don't require routine call schedule. You may be required to handle acute pain service at night and cover 2-3 call weekends in the year give or take.

 

[sevoflurane]

I love regional... but doing blocks all day long and running a pain service is NOT MY THING.

I used to be in a program that a had a busy regional service. Blocks all day long. from 6:45- 5pm. By the end of the month, I was always ready to get back into the OR and do the fun cases. A busy pain service will absolutely keep you running all day long.

 

[Dejavu]

No, but there are jobs in ortho hospitals where you place 20 blocks a day and loosely supervise CRNAs.

I am no billing expert, but I don't think I would bill Medicare for blocks done while supervising rooms.

Where I work we have two block people every day so we can do blocks pre-op. Our billing people tell us that we cannot bill for blocks done while supervising rooms. We would be working for free.

Unless the CRNAs are billing as non-medically directed, I suppose. But like I said, luckily, I don't have to be a billing expert. We have people for that.

We just do what they say, in order to avoid Medicare fraud and jail.

 

[Oggg]

I don't supervise multiple rooms, but I don't understand why you can't bill for blocks done in the OR or anywhere for postop pain. We routinely subtract procedure minutes for blocks done for postop pain only (typically 1-10min).

 

[Mman]

Billing for a block while supervising rooms happens all day every day without issue, Medicare included. The problem you could run into is billing a block done for postop pain preoperatively. Depending on the payer, they might not go for your anesthetic bill and your pain bill.

But if your billing company thinks you can't supervise some CRNAs and bill for a postop block...well you need a new billing company.

 

[dhb]

Can anyone comment on this? I've heard people talk about this but it sounds too good to be true.

Why would you want to do this?

 

[Consigliere]

Billing for a block while supervising rooms happens all day every day without issue, Medicare included. The problem you could run into is billing a block done for postop pain preoperatively. Depending on the payer, they might not go for your anesthetic bill and your pain bill.

But if your billing company thinks you can't supervise some CRNAs and bill for a postop block...well you need a new billing company.

True. We do this DAILY as well.

 

[epidural man]

the question was

"Can you really get a job doing only regional blocks?"

This means no supervision, no running a regional or acute pain service, no doing any anesthesia in the room.

The answer is - no group would hire someone just to do blocks and do nothing else. A person like that would be absolutely useless.

 

[imfrankie]

Can anyone comment on this? I've heard people talk about this but it sounds too good to be true.

I expect the reality is you would quickly become bored out of your mind.

 

[Dejavu]

True. We do this DAILY as well.

Like I said, I am truly not smart about billing, apparently. Luckily, I don't have to think about it.

Most of what I was talking about was preop pain blocks (fem, psoas cath, etc). Interscalenes done preop before shoulders.

They tell us we can bill for them if the block is done in the OR before GA induction, but someone else has to do the block in the "block shop" that we have in order to bill.

We even seem to think that a postop Ax Cath in PACU after an elbow or a rescue block in PACU cannot be billed for if the covering anesthesiologist is supervising any rooms.

Is our billing dept reading things wrong?

 

[B-Bone]

our billing company (and the anesthesia coding/billing lawyer specialist they keep on retainer) says we can be supervising up to 3 rooms while doing nerve blocks for post-op pain control. They say it counts as an additional room. They say we can't bill for out-of-OR procedures that aren't for post-op pain control (blood patches, LP's, central lines in the ICU, etc) while signed in to any rooms. we frequently have someone sign on to one room to make us "legal" to do a block when we have four rooms.

 

[Mman]

our billing company (and the anesthesia coding/billing lawyer specialist they keep on retainer) says we can be supervising up to 3 rooms while doing nerve blocks for post-op pain control. They say it counts as an additional room. They say we can't bill for out-of-OR procedures that aren't for post-op pain control (blood patches, LP's, central lines in the ICU, etc) while signed in to any rooms. we frequently have someone sign on to one room to make us "legal" to do a block when we have four rooms.

all our experts (legal and billing) say it's perfectly fine supervising 4 rooms and doing a postop block for pain in the PACU. Medicare and private insurers all reimburse without problem and they've never heard of a problem in that situation.

Agree about things like blood patches, though. We let them sit around until somebody's rooms are done and then they can do it. After all, a blood patch is never an emergency.

 

[nimbus]

Just like JCAHO, seems like everyone has there own interpretation of the rules. My own group started imposing billing rules that penalize those who do a lot of high acuity cases.