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Modifier on 01996?

  1. Default Modifier on 01996?
    Medical Coding Books
    Is an anesthesia modifier such as AA required on 01996? I am getting conflicting info from different sources and need some expert advise!!


  2. #2
    If I'm not mistaken, 01996 is for the hospital to bill to get reimbursed for the daily maintenance of an indwelling catheter. A physician is not normally involved in this, so AA would not be appropriate.
    Walker Bachman, CPC, CPPM

  3. Default
    Actually, 01996 is most commonly used by anesthesiologists for follow up care for continuous epidural catheters. Some payers, such as Medicare of GA, AL and MS require an AA mod, even though it isn't for anesthesia, it is technically in the anesthesia section of CPT. So, my answer is yes, but check with your carrier. Hope this helps

  4. #4
    I'm located in Nebraska and none of my payers (commercial or governmental) require a modifier on the 01996 code.

    Julie, CPC

  5. #5
    Check in your payer policies for anesthesia - most don't but some do (In Mass - HPHC and Fallon for example). Others will deny the claim if you attach AA - and the payer doesn't want it.

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