Anesthesia Coding Alert

Question: Our CRNA administered a labor epidural. He constantly monitored the patient while the surgeon attempted to turn the breech baby. The procedure took one and one-half hours but was unsuccessful. The patient went directly to surgery for a c-section that the same CRNA monitored. How should I code this case?

New York Subscriber  

Answer: Youre basically looking at a failed vaginal delivery followed by a c-section (652.20, Breech presentation without mention of version; unspecified as to episode of care or not applicable).
 
Report the attempted version 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]) plus the applicable time units. Code the c-section as +01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [list separately in addition to code for primary procedure performed]) with the applicable time units. The start time for the c-section should be the same as the end time for the vaginal delivery.

If the carrier requires surgical codes, report 59412 (External cephalic version, with or without tocolysis) for the attempted version and 59514 (Cesarean delivery only) for the c-section.