Anesthesia Coding Alert

Question: The anesthesiologist provided an epidural for a vaginal delivery, followed immediately by additional MAC anesthesia for episiotomy repair due to bleeding. Can we bill the anesthesia as two separate procedures since the delivery was under epidural and not MAC?

Connecticut Subscriber

Answer: No, you should not report both types of anesthesia as separate procedures.

Here’s why: When the provider administers anesthesia for multiple surgical procedures during the same encounter, you should report the anesthesia code representing the most complex procedure. You combine the times for all procedures, however, to report under the single anesthesia code.

In the scenario you describe, the epidural administration would be represented by code 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)). Submit this code with the total amount of time from epidural placement through the hand-off to post-op care after the episiotomy.