Revenue Cycle Insider

Question: My doctor inserted a labor epidural (01967) at 8 in the morning and then in the afternoon the obstetrician did a cephalic inversion (01958). The patient didn’t deliver until later that night by C-section (01968). I know that we code to the highest level of service, but would the cephalic inversion be a separate case that would be billed for separately, and then just bill non-continuous time for the 01967/01968?

Nevada Subscriber

Answer: Although these three codes are not bundled by the National Correct Coding Initiative (NCCI) edits, as you’ve mentioned, the highest level of service is reported with all time. Since this was an ongoing case with an existing epidural catheter, the highest levels of service are the epidural and C-section with a combined base value of eight units. Depending on the patient’s payer, epidural coding may have specific requirements, such as face time. If that is the case, time for the cephalic version will be included in the reported time. If not, and your group follows one of the methods suggested by the American Society of Anesthesiologists (ASA), the time for the cephalic version will still be included. Although it appears the NCCI allows it, according to anesthesia coding rules, you would not bill 01958 (Anesthesia for external cephalic version procedure) separately. It is important to follow payer policy, if policy is available.

Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPMA, CPC, CPC-I,
Perfect Office Solutions, Contributing Writer