Anesthesia Coding Alert

Question: When billing for code 01967, sometimes the time is over 999 minutes. In one case, the time was 1,080 minutes. May I bill the anesthesia as: 01967 (900 mins in the units field) plus 01967 (180 mins in the units field), or should I report it some other way?

Indiana Subscriber

Answer: Knowing how to handle multiple-digit units can be difficult. You typically report minutes in field 24G on the CMS (HCFA) 1500 form. Most payers that accept claims electronically can accept a maximum of three digits in that field, whereas some payers that only accept paper claims and don't accept electronic claims -- some workers comp or auto injury payers, for example -- scan in only two digits in the 24G field.

But this limitation should not present a problem in your case. Here's why: For 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]), you should fill the units field with time units, not minutes. Your listed units should show how many minutes equal one unit. Many payers use a standard of 10 to 15 minutes equaling one time unit.

Assuming in your case 15 minutes equals one time unit, 900 minutes equals 60 time units (or 15 hours multiplied by four time units per hour). Likewise, the 180 minutes would equal 12 time units. That's a total of 72 time units which will fit into your two- or three-digit field.

Bonus tip: Some insurance companies may require you to report time. If software limitations keep you from reporting the correct time, rather than report 01967 twice with the time divided between two lines, you could drop the claim to paper and hand-correct it, attaching a copy of the report to substantiate the time.

FYI: Keep an eye on your carriers. Many cap the anesthesiologist's labor at a given level. You can find that information in their anesthsesia policies by contacting them directly.