# help - places the epidural



## justcode (Dec 17, 2008)

scenario:  Dr.A is on schedule from 7am to 7 pm.  Dr. A got called for a c-section case.  A pt needs epidural placement, but Dr. A can't do it (he's in OR for C/S), so they called another physician Dr. B.  So Dr. B places the epidural, has contact with patient for 30 mins., then leaves.  In the meantime, Dr. A is done with the C/S case, and nurse tells Dr. A that Dr. B placed the cath on Patient 2.  now the question is: how do i bill for Dr. A & Dr. B?  This is not a split case because it happened between 7am -7pm.

most insurances asks for the contact time in this scenario Dr. B has contact time of 30 mins.  And Dr A on the otherhand, after the c/s case, he did not have contact with patient 2 but he is the dr on schedule.  so how would i bill this and how should documentation look like.

confusing i know!!! pls help!!!


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## jdrueppel (Dec 17, 2008)

Are Dr. A and Dr. B in the same practice?   Is there any documentation by Dr. A on the anesthesia record, who d/c'd the epidural?  Epidural anesthesia for vaginal delivery is not considered a continuous face-to face (which you state as contact time) service. You have a couple options depending on the documentation.  You could bill 62319 (epidural placement only) or possibly bill 01967 (it appears by your question that Dr B placed epidural for vaginal delivery) with attendance time at your standard charge. We have a dedicated OB anesthesia provider each day on the OB floor. In the case of an insurance company that requires only reporting face-to-face time we still enter total time but edit the claim form to report only contact/attendance time. 

OB anesthesia documentation requirements can vary by facility guidelines.  Our facility requires a minimum of hourly documentation on a labor epidural.  


Julie D, CPC


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