01967 CRNA 01968 MD Took Over

Melissa-ASL-PMB-07

Networker
Messages
98
Location
Richmond, IN
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Hello,
Would the following be appropriate to bill as two separate claims?

Labor Epidural started by CRNA and remained available to patient until sign over to MD to provide case of Cesarean.
MD present for Cesarean Only.
This is all within the same group.

Should this be billed as:
Option 1
Claim 1: 01967+TM QZ
Claim 2: 01967 AA (0 units), 01968+TM

Option 2
Claim 1: 01967+TM QZ
Claim 2: 01961+TM AA

Option 3
Claim 1: 01967+TM QZ 01968+TM QZ filing all under CRNA and internally reimburse MD the deserved payable units?

Please advise. We are struggling with this since the MD will not be paid appropriately at the CRNA rate.
Thank you in advance!
~Melissa, CPC
 
Last edited:

LisaAlonso23

Expert
Messages
312
Location
Sherman, TX
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Option 1 is your only option.

Option 2: you may not code 01967 and 01961. When a vag delivery converts to a c-section, you would use 01967 followed by 01968.

Option 3: this would be fraudulent billing, as the CRNA didn't provide anesthesia services for 01968.
 
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