Anesthesia Coding Alert

Question: Should we report 62311 or 62319 for placement of an epidural for delivery in addition to the 01967 for the actual delivery? Kansas Subscriber Answer: Carriers would normally consider reporting 62311 (Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]) or 62319 (Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]) for epidural placement along with 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 actual delivery as double-billing. If you have a carrier that will pay for both codes, be sure to get clear documentation of the policy before coding that way, and don't bill other carriers in a similar manner.

Correct Coding Initiative (CCI) edits prohibit billing codes 62311 and 62319 with 01967. Many carriers follow CCI, so you should closely adhere to their guidelines.