Anesthesia Coding Alert

Tip: Be sure your charges reflect intensity and time Sometimes it seems that there are as many ways to report labor epidurals as there are women who need them, but you can sort through this maze of codes with these simple tips.

"There's no national standard for this service, so bill by whatever is appropriate in your area," says Tonia Raley, CPC, claims manager with Medical Information Management Solutions in Phoenix. Keep this information from the American Society of Anesthesiologists (ASA) in mind when you're billing for obstetrical anesthesia.

"Unlike operative anesthesia services, there is no single, widely accepted method of accounting for time for neuraxial labor analgesia," ASA guidelines state. "Professional charges and reimbursement policies should reasonably reflect the intensity and time involved in performing and monitoring any neuraxial labor analgesia."

The guidelines continue by listing four methods to determine professional charges that are consistent with these principles:

Basic units plus patient contact time (insertion, management of adverse events, delivery, removal) plus one unit hourly

Basic units plus time units (insertion through delivery), subject to a reasonable cap

Single fee

Incremental time-based fees (e.g., 0<2 hours, 2-6 hours, >6 hours). For information on ob billing options, visit the ASA's Web site at www.asahq.org.