05/19/2015 – 99231 vs. 01996

Question: The patient had a post-operative pain management injection or epidural, and the anesthesiologist makes a subsequent hospital visit. How do I know which CPT code 99231 or 01996 to use?



01996 is defined as “daily hospital management of epidural or subarachnoid continuous drug administration.” Examples of injection codes are: 62318 and 62319.


99231 is defined as “subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or of low complexity.”  Examples of injection codes are:  62310-62311, non-continuous injections.

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