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December 2016 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 9 Physician : 9.2 Services, Benefits, Limitations, and Prior Authorization : 9.2.50 Pain Management : Epidural and Subarachnoid Infusion (Not Including Labor and Delivery)
Epidural and subarachnoid infusion for pain management is payable for acute, chronic, and postoperative pain management.
Procedure code 01996 is limited to once per day and is denied when billed on the same day as a surgical/anesthesia procedure. Procedure code 01996 billed longer than 30 days requires medical necessity documentation. Cancer diagnoses are excluded from the 30-day limitation.
Procedure code 01996 is payable to CRNAs and physicians.

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