Anesthesia Coding Alert

Question: The obstetrician placed an epidural for labor and delivery, but the patient needed a c-section. Our anesthesiologist was called in for the c-section and used the already existing epidural for injecting additional anesthesia. How should I code the anesthesiologist's service?

Florida Subscriber

Answer: This one is a little tricky because reporting the patient's conversion to a c-section when the obstetrician placed the epidural is hard to explain with the codes available. If the carrier allows, you may be able to report +01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/ anesthesia [List separately in addition to code for primary procedure performed]). Submit the claim with records showing that the obstetrician placed the epidural. You may bill the anesthesiologist's time for the c-section and the full value of code +01968 (which is 3 base units). However, since +01968 is an add-on code, your carrier may require that you report 01967 as a primary procedure code. In that case, you can report 01967 with a zero dollar value indicating the obstetrician place the epidural in Box 19 or the electronic equivalent. This is not typically a situation that occurs often!