Anesthesia Coding Alert

Question: I am billing an OB case that started as a continuous labor epidural for a planned vaginal birth just before midnight on day 1. The case shifted to a C-section on day 2. I believe the continuous epidural should be billed for day 1 and the add-on code +01968 billed for day 2. Is this correct? Should I separate the anesthesia services between dates?

Wisconsin Subscriber

Answer: The correct way to input the information depends on your billing system’s setup. You will need to report two codes:

• 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)
• +01968 – Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed).

Include whatever diagnosis codes apply to support each portion of the labor and delivery. Enter your provider’s time from the beginning of service for 01967 until the end of service for +01968. The claim should include a field to enter the start time of +01968. The fact that the date changed only means that you should indicate the correct day and time for the start and stop times associated with each code. Both 01967 and +01968 should be submitted on the same claim.

Tip: An exception would be any insurance company that required the start date as both dates of service. For example, although Medicare labor epidural patients are rare Medicare requires the initial date of service is reported for services that span after midnight.