Daily Management Of Epidural


Bristol, VA
Best answers
I am fairly new to billing anesthesia. I have a CRNA that performed a daily management of an epidural. I have tried to bill one unit per day for CPT 01996. However, the clearing house indicates Medicare is still requesting minutes and units over 1. Please advise..... I read the code as daily which would be a unit of one per day, but I am being instructed otherwise. Any help would be greatly appreciated. Thank You!:confused:
That code should be one unit and only one unit can be charged per day but it should not have any modifier like QZ etc.... In my state, Ohio, Medicare does not cover that code when done by a CRNA even though they cover the anesthesia service for the surgery which requires the placement of the epidural cath and management of the pain when preformed by a CRNA. They do not deny it but rather reject the claim stating "invalid procedure code." In this state, they also do not cover 62318 or 62319 for post op pain management when done by a CRNA and it cannot be billed "incident to." You can imagine how angry the Anesthesiologists are about that. You should check with your carrier to see what the local rules are on CRNAs. Sometimes they are limited by the "scope of practice" in some states. Best of luck.
Holly M.
OK...this is how we do it

I bill for Arkansas and we aren't allowed to bill using a CRNA for epidural management. But this example may help...when we bill for Medicaid, they require what you're stating Medicare requires in your state. We place a P1 modifier, 15 minutes of time and 03 (Epidural) for the method. That should make the units over 1.
I live in kentucky and i work for pain management--when i bill for daily management to m'care/m'caid i dont have any problems using 01996- but of course even though the dr i work for is a anes. his credentials is for pain management