Anesthesia Coding Alert
Don’t Include +01969 if Patient Has No Labor Analgesia
Question: I am coding for a patient who did not have labor analgesia but later had anesthesia for a cesarean section that progressed to a hysterectomy following delivery. I have coded this as 01961 with add-on code +01969. The insurer is denying the +01969, stating that a qualifying procedure was not billed. Are these codes not billable together? How should I be billing this encounter? New Mexico Subscriber Answer: Your best option is to report 01963 (Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care) for the full amount of time your provider was caring for the patient. Here’s why: Although codes 01961 (Anesthesia for cesarean delivery only) and +01969 (Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)) seem to cover the services provided, notice that the descriptor for +01969 mentions that the patient had labor analgesia or anesthesia. Since the patient you’re coding for did not have labor analgesia, code 01963 better describes the situation and will cover both a c-section and hysterectomy carried out during same session.
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