Anesthesia Coding Alert

Question: Some of our physicians assist with deliveries at a local hospital with a huge obstetrics program. It seems like all of the physicians who deliver there count every delivery as an emergency. What constitutes an emergency delivery for coding purposes? What types of circumstances should be present and documented to qualify a normal vaginal delivery as an emergency?

New Jersey Subscriber

Answer: Never bill a vaginal delivery epidural as an emergency. Women have given birth for thousands of years without anesthesia, so our opinion is that labor epidurals are a convenience only. Some anesthesiologists may feel that epidurals are still elective and that certain circumstances may constitute an emergency. Some insurance carriers will reimburse this as an emergency, but others (such as Medicaid in California) will not.