Anesthesia Coding Alert

Question: I bill for obstetrics anesthesia: Our provider placed an epidural for delivery but then the baby went in distress. Can you please tell me what is the diagnosis code for placenta abruptio with or without hemorrhage during labor?

North Carolina Subscriber

Answer: Based on this small bit of information, it appears your primary diagnosis (the reason the labor epidural was placed) may still be O80 (Encounter for full term uncomplicated delivery) reported 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]).

If the epidural went to a C-section based on placenta aburuption, your diagnosis for the C-section reported with 01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [List separately in addition to code for primary procedure performed]) should come from the O45 (Premature separation of placenta [abruptio placentae]) series; the additional characters will fully explain the situation to the insurer.

For example, if the delivery happened during the thirdtrimester, then you may also report code O45.8X3 (Other premature separation of placenta, third trimester).