Ultrasound Guidance for Nerve Blocks
This guide provides information on coding, coverage, and payment for ultrasound-guided nerve blocks under Medicare rules.
Coverage and Payment
Medicare covers ultrasound guidance when reasonable and necessary for diagnosis or treatment. Payment varies based on the site of service, with separate payment available for physician offices but not for hospital outpatient departments or ambulatory surgical centers.
Private payer coverage for ultrasound guidance varies by payer and plan.
Coding and Documentation
Correct coding and documentation are crucial for proper payment. Separate written records of the ultrasound visualization procedure must be maintained in the patient record, including image documentation.
Examples of CPT codes used to report nerve block procedures that may require ultrasound guidance are provided in Attachment A.
Manual:
Download: Ultrasound Guidance for Nerve Blocks: Coding, Coverage, and Payment
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