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Peripheral Nerve Block for Pain Management after Total Knee Arthroplasty

Published on 

Wednesday, March 8, 2023

 | Coding 
 | Documentation 

Did You Know?

A peripheral nerve block (PNB) may be reported for postoperative pain management following a Total Knee Arthroplasty (TKA), if not captured by the hospital’s Chargemaster.

Why It Matters?

Various studies have shown that PNBs following a TKA can deliver safe and effective pain relief. This type of pain relief can improve postoperative pain, patient satisfaction, and decrease the need for opioid use. Coding PNBs do not affect the DRG; however, reporting a procedure code for PNB will give a more accurate clinical picture of what was required to take care of that TKA patient.

Also, an ICD-9 Coding Clinic noted that coding a procedure for management of postoperative pain was permissible.

What Can I Do?

  1. Review documentation from the Anesthesiologist that indicates the surgeon requested a PNB for postoperative pain management. This documentation is typically found on a Pre-Anesthesia Evaluation sheet. Types of PNB: Femoral, Obturator, Sciatic, Lumbar Plexus, and Adductor Canal Nerve.
  2. Contact the business office to see if this procedure was captured in the Chargemaster.
  3. Verify if there is a hospital policy for coding secondary procedures that do not affect the DRG.
  4. Educate coding staff.

References:

Coding Clinic, 2nd Quarter 2000, page 14

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353705/

Review on Nerve Blocks Utilized for Perioperative Total Knee Arthroplasty Analgesia | Published in Orthopedic Reviews (openmedicalpublishing.org)
Article Author: Anita Meyers, RHIT, CCS
Anita Meyers, RHIT, CCS, is an Inpatient Coding Professional at Medical Management Plus. Anita has over twenty-six years of experience in inpatient and outpatient coding including 17 years of work at AQAF reviewing inpatient and outpatient records from Alabama hospitals. In addition to reviewing records she was the team leader in Beneficiary Services where she participated in case review activities, received and processed beneficiary complaints and handled fee-for-service denials for home health, hospice and skilled nursing facility services. Prior to joining the MMP team, Anita left AQAF to become an inpatient contract coder and worked at various hospitals in central Alabama. In her current position, Anita is an integral part of the Inpatient Services at Medical Management Plus.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.