Anesthesia Coding Alert
Verify Continuous Infusion for 01967 to +01968 Shift
Question: A patient received an epidural that our provider noted as code 01967 for the first day and as +01968 on the next day. The insurer is denying the claim due to the epidural being given on different days. Is there documentation stating whether providing the service this way can or cannot be done? Arkansas Subscriber Answer: Begin by checking your provider’s documentation. In many cases, the epidural represented by 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)) probably was continuous until the change to +01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)). If so, bill both epidurals with the same date of service but report the correct time designations for each. Because +01968 is an add-on code, some payers may want the service billed on the same day as 01967 even if the actual shift to +01968 took place the next day.
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