# Labor Epidural Coding ?



## missyah20 (Sep 11, 2008)

I have a coding scenario and I am hoping someone can give me some insight.  I have a patient who was given a labor epidural by the MDA, but the CRNA then did the rechecks and the vaginal delivery w/o any medical direction.  How would you code this? 

Thanks in advance!


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## jdrueppel (Sep 24, 2008)

This happens frequently in our practice.  We are a practice of MDAs & CRNAs in Nebraska.  In the state of Nebraska, CRNAs are able to personally perform (QZ) services.  The CRNAs are our employees. We do NOT bill medical direction OR supervision for any of our CRNAs. 
1) Is the CRNA your employee or within the same group as the MDA? If not, will another entity be billing for the CRNAs service?
2) Does CRNA licensure allow services to be billed without medical direction or supervision?
3) Who is the payer?  Does this payer have billing specifications?

In the situation you explain, for all of our payers, we bill total time (for both MDA and CRNA) 1 charge under the provider with the most time on the case.

Hope this helps.

Julie


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