Nerve block question/billing
Not sure this is the right place to ask…but here's some minor backstory:
I'm a 36/m/TN with an income of about 50k-55k a year. 2 years ago I was diagnosed with a rare (for males) debilitating condition called pudendal neuralgia, that causes constant pain in my groin area. I saw a urologist for it, and he said the only options are either muscle relaxers or a periodic nerve block, since the condition is still not well understood.
I don't want to be on muscle relaxers, so I'm considering the nerve block route. Before I go though the process of trying to get treated, I'm trying to figure out if this would be a neurologist, gastroenterologist, or a urologist that would perform this procedure. The urologist is the one that diagnosed me, but honestly I'm assuming the specific area that whatever specialist would have to deal with is my rectum for the block itself.
I've also spoken to BCBS, and they cannot price the procedure without the specific CPT code. I'm assuming the description would be "pudendal nerve block," but I want to make sure I get the correct code(s) to give to BCBS, so I don't get shocked by a bill potentially not being covered, if there's any sort of miscommunication.
Has anyone dealt with billing for this before, or have any advice? I'm sure my diagnosis of "pudendal neuralgia" would prove medical necessity for the nerve block, seeing as that's the most common course of action, but I want to make sure I have the right information before I contact both BCBS and a specialist again.
submitted by /u/Marx615
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