Anesthesia Coding Alert

Question: Other coders in our department are using 01996 only for epidurals. If the anesthesiologist places some other kind of block, they’re using a two-unit consult code for the daily management. Is that right, or should they be coding 01996 for situations other than epidurals?

Connecticut Subscriber

Answer: Your coworkers are correct. Code 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration) should be used for daily management of a continuous epidural or subarachnoid drug administration after the anesthesiologist places an epidural or subarachnoid catheter for postoperative pain management.

The descriptors for several common blocks used for post-op management no longer include daily management: 

• 64416 – Injection, anesthetic agent; brachial plexus, continuous infusion by catheter (including catheter placement) 
• 64446 – … sciatic nerve, continuous infusion by catheter (including catheter placement) 
• 64448 – … femoral nerve, continuous infusion by catheter (including catheter placement)  
• 64449 – … lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement).

Coding notes with these procedures specify that you should not report these codes in conjunction with 01996. Instead, when your provider uses one of these types of blocks for post-op pain management, you should report the block code based on the anatomic site and the appropriate E/M code.