Anesthesia Coding Alert

READER QUESTIONS:

Study 654.21 for Requested Cesarean

Question: Our physician performed anesthesia for a c-section and I billed 01961 for that. I am worried about showing medical necessity for the c-section because the doctor documented "patient desires c-section, previous shoulder dystocia." What diagnosis code should I use?

Georgia Subscriber

Answer: Determine your coding here by whether the patient had a previous c-section due to shoulder dystocia.If so, look to 654.21 (Previous cesarean delivery).

If no previous history of c-section exists, Coding Clinic 2001 first quarter directs you to report 669.71 (Cesarean delivery, without mention of indication) for this scenario.

Remember: You should use 01961 (Anesthesia for cesarean delivery only) only when the situation is a primary c-section that does not involve any labor care.

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