Splanchnic nerve block / celiac plexus billing

[Papa Lou]

For Code 64530 (celiac plexus block) where we would typically block anterior margin of T11 or T12 vertebral bodies for the splanchnic nerves what are you guys billing as the ICD 10. I just found out Medicare is denying payment for our diagnoses (which is chronic pancreatitis, abdominal pain).

How are you guys coding to get it paid?

Clinically she's on number 4 on a series and is on half her pain meds loving life. I haven't been paid for any it turns out.

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[Agast]

There's an online list of local determination codes for Medicare that my insurance girl uses. I think it's under cms.gov

 

[Ducttape]

Excluding a cancer diagnosis, I have stopped doing celiacs for Medicare.


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[lobelsteve]

For Code 64530 (celiac plexus block) where we would typically block anterior margin of T11 or T12 vertebral bodies for the splanchnic nerves what are you guys billing as the ICD 10. I just found out Medicare is denying payment for our diagnoses (which is chronic pancreatitis, abdominal pain).

How are you guys coding to get it paid?

Clinically she's on number 4 on a series and is on half her pain meds loving life. I haven't been paid for any it turns out.

Single block then turf to GI for endoscopic neurolysis or IR for CT neurolysis. Would deny 2-4th block as unreasonable.

 

[Extralong]

Aren't you worried that GI is taking over those blocks with endoscopic ultrasound? At least at ASIPP I learned that GI is not only claiming they have better results, they are claiming our celiac blocks are too dangerous to continue and should be cut. Just saying.

 

[lobelsteve]

Aren't you worried that GI is taking over those blocks with endoscopic ultrasound? At least at ASIPP I learned that GI is not only claiming they have better results, they are claiming our celiac blocks are too dangerous to continue and should be cut. Just saying.

Let them have em. And dont take their opiate dumps when the blocks fail.

 

[Papa Lou]

Thanks guys. I guess that's the last one I'm doing. Too bad I really enjoy doing them when they work. Will refer to GI

 

[Ducttape]

the risk/reward for celiac blocks is, outside of cancer care, not worth it.