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CPT intra-nasal sphenopalatine ganglion block

Mike Posted Wed 10th of June, 2015 14:02:47 PM

What would be a CPT code for intra-nasal block by cotton swab??? Can the Marcaine be billed, usually this supply is not allowed. See noted below:

Her nares were then inspected and found to have no lesions or masses. At that point, a 6-inch cotton swab soaked in 0.75% Marcaine was gradually advanced into her nares and eventually placed at the posterior aspect of her nasopharynx along the superior nasal turbinate. This was then performed on the patient's left side. Approximately 0.2 mL of 0.25% Marcaine was then dripped along the cotton applicator on either side and left in place for approximately 15 minutes. The cotton applicators were then removed, and this exact same procedure was performed again bilaterally. These cotton swabs were again left in place approximately 20 minutes. At that point the cotton applicators were removed. In total, approximately 2.5cc Marcaine was administered.

SuperCoder Answered Thu 11th of June, 2015 06:13:27 AM

Well, most Medicare contractors do not pay separately for marcaine unless it is in an implanted infusion pump. And here block is given by cotton swab, so I am afraid it will not be paid. It is suggested to code E/M service only.

Mike Posted Thu 11th of June, 2015 10:47:32 AM

not even an unlisted code?

SuperCoder Answered Fri 12th of June, 2015 02:54:53 AM

Well, medicare will not pay even an unlisted code for the procedure performed. But you can confirm it with your commercial payer.

Mike Posted Fri 12th of June, 2015 17:02:10 PM

Could 99199 be use for this procedure? I understand commercial payers may not pat, but I must use some code for this procedure.

SuperCoder Answered Mon 15th of June, 2015 03:56:07 AM

Well, I doubt the payer will pay for this. You can try if you want, but I suggest to review your complete documentation to coded unlisted procedure. CPT 30999 also the unlisted procedure of nose. Hope it helps!

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