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64486/64488 TAP Block

Kathy Posted Wed 02nd of December, 2015 12:53:06 PM

Is there a list of CPT's the TAP Block codes, 64486 & 64488 are bundled into?

Also, can you explain why this would be billable & payable, if this procedure is performed by an Anesthesiologist instead of the surgeon?

Please site resources. Thank you!

SuperCoder Answered Thu 03rd of December, 2015 08:30:42 AM

Thanks for the query!

This year four new codes have been added that differentiate between an injection and continuous infusion and whether the provider administered a unilateral or bilateral injection.
It is not necessary that only Anaesthesiologist will perform these procedures rather sometimes Providers use transverses abdominis plane (TAP) catheters as an alternative to epidural analgesia after upper abdominal surgery or as an adjunct to anaesthesia during an abdominal laparoscopic procedure. This is the reason why these codes are billable & payable.

You can find list of CPT's that are bundled into TAP Block codes 64486 & 64488, you can refer CCI-Edits for that code in SuperCoder (https://www.supercoder.com/cpt-codes-range/1899/20)

Kathy Posted Thu 03rd of December, 2015 18:16:28 PM

There's a HUGE discrepancy here...

I just went thru all the CCI edits(via the link above) for both 64486 & 64488. There are Category III codes as well as Medicine & Radiology codes listed, but the ONLY surgical procedure codes they list are: 12001-12057; 13100-13153; 36000; 36400-36440; 36591-36592 & 36600.

When I ran codes 49657 & 64488 thru the "SuperCoder CCI Edits Checker" (not thru the above link), it shows 64488 is bundled into 49657 & cannot be unbundled for any reason.

I'd be interested in understanding why 2 resources thru SuperCoder are providing completely different information.

ALSO, my surgeons are being advised by anesthesiologists, that they ARE getting reimbursed for the codes 64486 & 64488, during surgical procedures, so again... is this because we are Surgeons and not Anesthesiologists?

Please look into this further & update me. Again, please site your resources. Thank you.

SuperCoder Answered Fri 04th of December, 2015 07:13:29 AM

According to NCCI, Medicare Global Surgery Rules prevent separate payment for postoperative pain management when provided by the physician performing an operative procedure. CPT codes 36000, 36410, 37202, 62310-62319, 64400-64489, and 96360-96376 describe some services that may be utilized for postoperative pain management. The services described by these codes may be reported by the physician performing the operative procedure only if provided for purposes unrelated to the postoperative pain management, the operative procedure, or anaesthesia for the procedure.

Above mentioned link for list of CPT's that are bundled into one code is a kind of sample code list which is in a broad way but it is highly recommended to crosscheck any conflicts in CCI Edits Checker for correct coding.

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