Anesthesia Coding Alert

Question: Physician A administered an OB epidural; Physician B checked on the patient 15 minutes later and replaced it. Can both physicians bill for their placement?

Answer: The anesthesia code for labor epidural placement is 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]). Once you read through the entire descriptor you see that the code includes initial placement and any replacement. Because of this, you cannot submit additional or separate charges for replacement, even if a different physician provides the service.

Selection: Choosing which physician to report with the service depends on the circumstances. In a teaching hospital, submit the service for Physician A because he placed the initial epidural. Sometimes groups in a non-teaching situation report the service according to which physician spent the most time on the case. Check your group's guidelines for clarification.