Anesthesia Coding Alert
Match Anesthesiologist and CRNA Codes for C-section Case
Question: The anesthesiologist provided the epidural for the labor portion of a delivery. Then he directed a CRNA during the C-section portion of the encounter. The anesthesiologist bills 01967-AA and 01968-QK or QY. My question is, what does the CRNA bill? Some people in our office say it should be 01961-QX.
Montana Subscriber
Answer: The anesthesiologist and the CRNA should bill with the same ASA codes: 01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [List separately in addition to code for primary procedure performed]) with modifier QX (CRNA service: with medical direction by a physician). Code 01961 (Anesthesia for cesarean delivery only) indicates that only a C-section was performed and that the patient did not receive any labor analgesia/anesthesia, which is not the situation in your case.
In addition, RVG guidelines state that you should not report code 01961 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]). This patient had a trial of labor. Therefore, it would be inappropriate to bill 01961.
Tip: Be sure the diagnoses for the labor epidural and the C-section are not the same code.
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