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Anesthesia Coding Alert

You Be the Coder:

Know When to Bill 01996

Published on Mon Nov 22, 2004

Question: The anesthesiologist made a change in a patient's post-op medication being administered through a continuous catheter. He discontinued the catheter later the same day. What guidelines apply to 01996? Can we report it on the day the physician discontinues the catheter?

South Carolina Subscriber

Answer: You can begin reporting 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration) the day after an anesthesia provider inserts the catheter for post-op pain management. An anesthesia provider must perform some type of management each day for you to bill it daily. Some carriers set a maximum for the number of days they allow you to bill 01996 without prior approval or documentation of special circumstances (four days seems to be a popular guideline). Check your carrier's guidelines regarding this. You cannot bill 01996 on the day the physician discontinues the catheter, but you can report an appropriate office visit code instead. The correct code depends on the level of E/M service the physician performs and documents.
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