I decided to write an article on this topic for several reasons. First, there is little to no data on pain block utilization available to the public. Part of the reason is that it’s somewhat of an arduous process to calculate. Second, the best source of such information comes from billing companies who work with multiple anesthesia practices.
Unfortunately, most of these companies have either not performed this type of analysis or have done so and kept the results a closely guarded secret. My opinion has always been that if data or information is available that can help anesthesia practitioners, I’m going to share it. After all, our struggles are with the insurance community failing to pay legitimate claims, not each other.
Pain Block Utilization Analysis
With that being said, let’s dive into my analysis. As far as sample size, I looked at 20+ Anesthesia practices that performed post-operative pain blocks and reviewed a complete service year. Although pain blocks can be performed for multiple service lines, we’ll focus here on Orthopedics, since those cases have the highest block percentages.
Next, let’s analyze the specific types of pain blocks being utilized for these common orthopedic surgical procedures.
Finally, we’ll look at Orthopedic Surgical CPT codes commonly billed with post-operative pain blocks, which provides for a more granular view.
Putting Pain Block Utilization Insights into Action
So, now that we have this information, what can we do with it? There are several use cases for this kind of data. The first involves revenue estimates for new and existing service locations. By knowing what ASA and CPT codes are tied to blocks, we can more accurately forecast annual collections. The second utility this information can provide is in creating specific rules for pain blocks in your billing platform. For example, you may want a “flag” that triggers if no block is charted that meets your likelihood threshold. You may also want to identify types of blocks not typically associated with certain surgical procedures. This can help to pinpoint charting or coding errors for correction on the front end, prior to a claim being submitted.
In conclusion, your biller has this data and should supply it to you, upon request. Also ask for the average payment per block, as it will help your practice determine if a particular block is economically viable. Lastly, the analysis will show where an individual provider, and your practice as a whole, compares to national block utility benchmarks.
With the new planer block codes introduced in 2025, MSN Healthcare Solutions has put together this block reference guide for your practice to use. We hope that you find the information helpful.
Click the image below to download your PDF resource.
Hal has 30+ years of experience on both the payor and RCM side, with a focus in Anesthesia. He formerly worked as a senior claims approver at United Healthcare, as well as a compliance officer for multiple national anesthesia billing companies. His broad-based experience ensures that MSN clients have a resource for documentation and billing issues. His past speaking engagements include ASA, MGMA, Dartmouth, and Johns Hopkins.
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