Wiki Epidural for Patient In Labor

[Amy Pritchett]

I am needing guidance on a coding question. The patient presents in labor and fails to progress. She is given an epidural when she arrives and prepares for vaginal labor. The patient has a history of C-section. Due to the failure to progress, the physician orders an immediate C-Section on the patient.

My question:
If the epidural is placed for the vaginal delivery (01967) and then converts to cesarean section (01968). I am being told to code 01961 and I do not agree. Any thoughts??

 

[melzinser]

Wouldn't the correct coding be:

01967 neuraxial labor analgesia for planned vaginal delivery
+01968 anesthesia for c-section following neuraxial labor analgesia (list in addition to primary code)

My understanding this is how to code planned vaginal delivery that is converted to c-section.

 

[Amy Pritchett]

That is what I am asking. The codes would be 01967 and 01968, which I have. I am being told that is incorrect that we should code an 01961 which shows the patient just went in for a routine c-section.
Thanks

 

[melzinser]

just asking

Told by whom? Is it a payer?