Anesthesia Coding Alert

Question: Duramorph is a narcotic that may be administered as a single injection prior to removing the epidural catheter used for OB cesarean deliveries. The patient must be monitored for at least 24 hours after administration because of the risk of respiratory distress. Is the monitoring billable or is it included in the epidural injection? If the monitoring is billable, would you use 99231 or 01996? Washington Subscriber Answer: You can not bill the monitoring separately as 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient ...) unless certain conditions are met. To report this code, documentation must support the service, and the monitoring you describe doesn't meet those requirements. The anesthesiologist does not perform the monitoring, and monitoring is never billable. Some physicians may mark 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration) in error on their charge ticket for this [...]