Anesthesia Coding Alert

Question: I’m an anesthesia coder and ran across a situation that no one at my practice has encountered before. We code a capped charge for labor epidural patients. Recently, there was a case where the anesthesiologist inserted the epidural and pulled it out at 2:31 a.m. when blood was aspirated from the catheter. The baby was delivered at 3:42 a.m.

Do we stop charging anesthesia time at 2:31 when the epidural was taken out or 3:42 when the baby was delivered?

Illinois Subscriber

Answer: As a standard, the anesthesia time submitted on the claim should be consistent with the medical records. You should stop charging based on the time the anesthesiologist ended or transferred anesthesia care, which should be documented. Check the anesthesia times reported on either the anesthesia record or the labor and delivery log.

Keep in mind: There may be payers that define rules specific to labor and delivery patients and their anesthesia care. In that case, you would follow payer guidelines.