It is no secret that the reimbursement crunch forces facilities to be proactive in seeking out financial opportunities. I have found that one avenue of reimbursement that is currently being somewhat overlooked by hospital-based and freestanding ASCs is the chance to take advantage of the American Medical Association's (AMA's) recent clarification on the coding of pain management services.

According to the AMA, it is appropriate to report pain management procedures, including the insertion of an epidural catheter or the performance of a nerve block, for postoperative analgesia separately from the administration of a general anesthetic. In practical terms, this means two things:

Example of physician form to aid pain management coding Anesthetic: Clinical Indication (check one): ____________ ___ Surgical Anesthesia ___ Post-op Pain Control

When general anesthesia is administered and pain management injections are performed to provide postoperative analgesia for acute pain, they are separate and distinct services and should be reported separately. Whether the block procedure (insertion of catheter, injection of narcotic or local anesthetic agent) occurs preoperatively, postoperatively, or during the procedure is immaterial. You can