Anesthesia Coding Alert
Be Sure L&D Code Captures the Correct Level of Service
Question: I am coding for a patient who did not have labor analgesic. She did have anesthesia for a c-section that converted to a hysterectomy following delivery. I have coded this as 01961 with add-on code +01969. The insurance carrier is denying +01969, stating that a qualifying procedure was not billed. Are these codes not billable together? How should I be billing this? Oklahoma Subscriber Answer: Reporting 01961 (Anesthesia for cesarean delivery only) seems to be logical on the surface, but you aren’t coding for a cesarean delivery; you’re coding for a delivery and hysterectomy. Therefore, the better option is 01963 (Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care), which will cover a c-section and hysterectomy during same session. Another note: You also mentioned including +01969 (Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)) on your initial claim. When you look at coding guidelines, you’ll see that +01969 is intended for use in conjunction with 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)), not 01961.
Related Articles
Anesthesia Coding Alert
- Special Circumstances:
Clarify What Qualifies as 'Emergency' Before Coding with +99140
Remember the situation is the determinant, not the location. Certain circumstances can sometimes affect how [...] - Fee Schedule:
Watch for Little Change to Your CMS Reimbursement in CY 2020
Anesthesia conversion factor remains virtually the same. Changes will soon be afoot for reimbursement and [...] - Security:
Follow These 4 Tips—Not the Myths—to Better HIPAA Compliance
Pay prices upfront to avoid bigger costs later. Many practices (or covered entities, CEs) keep [...] - You Be the Coder:
Turn to This Code for Single-shot Cervical Epidural
Question: The physician gave the patient a single-level cervical transforaminal epidural to treat his radiculopathy. [...] - Reader Question:
Only Append Modifier 24 for Unrelated Care During Post-op Period
Question: I need some help in figuring out what we can bill for our involvement [...] - Reader Question:
Be Sure L&D Code Captures the Correct Level of Service
Question: I am coding for a patient who did not have labor analgesic. She did [...] - Reader Question:
Watch Mode of Anesthesia Before Reporting 62322
Question: The anesthesiologist placed a single-injection intrathecal block to interspace L2-3 during an inguinal hernia [...] - Reader Question:
Remember That 64616 Doesn't Qualify for 'Bilateral'
Question: When our physicians administer Botox for chronic migraines, we bill the HCPCS J code [...] - Reader Question:
Choose from G21 Family for Secondary Parkinsonism
Question: I know that certain conditions can affect anesthesia administration, especially something like Parkinson’s. But [...]
