Anesthesia Coding Alert

Question: An OB patient had an epidural on one day followed by a C-section the next day. Should we use the same date of service since 01968 is an add-on code or should we use 01967 on the day it was given and then use 01968 on the next day?

New Jersey Subscriber

Answer: You should 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 original epidural and 01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [List separately in addition to code for primary procedure performed]) on a separate line for the Cesarean section. Be sure to note the different dates of service.

Extra tip: Watch for denials for claims in this scenario. Some insurers will deny the claim if the service dates do not match. If that occurs, you can either use Box 19 or the electronic equivalent to point out that the C-section was performed on the following day.