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Wiki 01961 and 62311

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bwilliams1

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Does anyone have any information as to why Medical Assistance in PA has 62311 included with 01961, but will pay when billed with 01968?

Your help is needed asap please and thank you!!

BHayze
 
bhayze said:
Does anyone have any information as to why Medical Assistance in PA has 62311 included with 01961, but will pay when billed with 01968?

Your help is needed asap please and thank you!!

BHayze
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Hi,

For cesarean delivery, anesthesia given is general anesthesia and this is planned before hand, and no additional work up may be required;(01961)

Whereas, for 01968 is an add on code for anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia - Initially epidural injections may be required during labor pain and when this does not support a vaginal delivery, a c-section is planned suddenly; hence, CPT 62311 can be paid, I think.

Usually, two-three subarachnoid drug injections are given before beginning treatment for vaginal delivery - May be for two epidural injections we may get reimbursed, if this case is not bundled as explained above;

LM
 
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