Reader Questions:
Check With Carrier on 01991 and 01992
Published on Thu Sep 09, 2004
Question: We have some problems collecting payment when we report anesthesia services during a diagnostic or therapeutic nerve block or injection (when another provider performs the injection). Do you have any tips for improving our reimbursement odds for these codes?
Wisconsin Subscriber Answer: Many coders report 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position) and 01992 (... prone position) without problems from carriers. This can depend, however, on the carrier. Workers' comp in particular may not recognize 01991 and 01992, depending on which CPT version they use.
For example, Florida's workers' comp uses CPT 2001 or 2002, so they don't accept either code (both codes were introduced in 2003). Other carriers, such as TrailBlazer Medicare in Colorado, Maryland and other states, accept 01991 and 01992 but require an approved diagnosis to support the medical necessity of MAC.