Anesthesia Coding Alert

Question: Two of our CRNAs provided anesthesia during a labor and delivery case. The first CRNA inserted an epidural for labor analgesia, and the second provided anesthesia when the case changed to a cesarean section. How should I code for their services?


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Answer: If the CRNAs are in the same group and fall under the same identification number, you can bill under the CRNA who had the most time on the case. Report the total case time from start to finish, but just report one CRNA's name.

Exception: If the CRNAs follow a productivity pay scale, you should report their services separately. Report 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]) for the CRNA who started the case. Report +01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [list separately in addition to code for primary procedure performed]).

Include a comment on the second CRNA's claim explaining that the code for epidural placement is on another claim.

Answers to You Be the Coder and Reader Questions were were provided by Terry Celestino, CPC, with Northwest Anesthesiology SA in San Antonio; Barbara J. Johnson, CPC, MPC, owner of Real Code Inc. in Moreno Valley, Calif.; and Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver.