06/30/16 – 99231 vs. 01996


Question: I placed a lumbar epidural catheter for post-operative pain on a patient and provided rounds the next day. What CPT code should I use for the rounds, 99231 or 01996? And what is the difference between the two?

Answer:  The correct code for rounds on a continuous epidural catheter would be code 01996.

01996 is defined as “daily hospital management of epidural or subarachnoid continuous drug administration.” This code would be used for rounds on any continuous epidural catheter. 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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